老年糖尿病足持续皮下胰岛素输注期间免疫球蛋白和CRP变化与其下肢血管病变的关系

Relationship between Immunoglobulin and CRP and Its Lower Extremity Vascular Disease Changes in Elderly Diabetic Foot during Continuous Subcutaneous Insulin Infusion

目的:探讨老年糖尿病足(DF)持续皮下胰岛素输注(CSII)期间免疫球蛋白(IG)和CRP变化与其下肢血管病变(LEA)的关系。方法:选取2011年1月至2013年6月期间我院收治的老年DF患者80例作为观察组,另选取30例同期老年健康查体者作为对照组。观察组采取CSII和糖尿病足治疗。比较两组IG和CRP水平及LEA发生情况并分析老年DF患者IG和CRP与LEA的关系。结果:与对照比较,观察组治疗前的Ig A、Ig G和Ig M等IG水平均显著降低,血浆CRP水平均显著升高,且观察组治疗2周、1个月、3个月和6个月的IG水平均高于治疗前,血浆CRP水平则低于治疗前,差异有统计学意义(P<0.05)。观察组LEA发生率为27.5%,且发生LEA患者治疗前、治疗1周、治疗2周、1个月、3个月和6个月的IG水平均低于未发生LEA患者,血浆CRP水平则高于未发生LEA患者,差异有统计学意义(P<0.05)。Spearman关系分析结果显示老年DF患者Ig A、Ig G和Ig M等IG水平与其LEA发生率均呈负相关(r=-0.731,-0.722,-0.736,P<0.05),血浆CRP水平与其LEA发生率均则呈正相关(r=0.738,P<0.05)。结论:CSII治疗可降低老年DF患者CRP水平并提高其IG水平且IG和CRP与其LEA均相关,可通过提高患者免疫功能和降低CRP预防LEA的发生。

Objective： To investigate the elderly diabetic fot （DF） of continuous subcutaneous insulin infusion （CSII） during imrnune globulin （IG） and CRP and the change of vascular lesions in the lower limbs （LEA） relationship.Methods：From 2011 January to 2013 June period in our hospital of 80 patients with DF were selected as the observation group, the other 30 cases of heatthy elderly controls.The observation group adopted CSlI and the treatment of diabetic foot. The relationship between the 1G and CRP levels were compared between the two groups and the occurrence of LEA and analysis of IG and CRP in elderly patients with DF and LEA.Results： Compared with control,the observation group before treatment, lgA,IgG and lgM IG levels were significantly decreased, the level of plasma CRP increased significantly, and the observation group for 2 weeks, I months,3 months and 6 months of the level of IG was higher than that before treatment, the plasma CRP level was lower than that betbre treatment, the difference was statistically significant （P（0.05）. The observation group the incidence of LEA was 27.5%,and the occurrence of LEA before treatrnent, I weeks of treatment, treatment for 2 weeks, l months,3 months and 6 months of IG than that of non LEA patients, the plasma CRP levels were higher than those without the occurrence of LEA patients, the difference was statistically significant （P〈0.05）.Spearman relationship analysis results showed that the elderly patients with DF, IgG and IgM IgA IG levels and the incidence of LEA were negatively correlated （r=-0.73 1,-0.722,-0.736,P〈0.05）, the plasma CRP level and the incidence of LEA was positively related （r=0.738, P〈0.05）.Conclusion：CSll treatment can decrease the level of CRP in elderly patients with DF and improve the level of IG and IG and CRP and LEA are related, can enhance the immune function of patients and reduce the incidence of CRP in the prevention of LEA.