踝肱指数、血超敏C-反应蛋白测定与糖尿病足发病的相关性临床观察

Correlations between ankle brachial index,blood high sensitivity C-reactive protein and the incidence diabetic foot

目的:通过踝肱指数(ABI)、血超敏C-反应蛋白(hs-CRP)测定,评估与糖尿病患者糖尿病足发生的相关性及病情预后,以便早期预测其相关危险指标,及早采取有效措施预防糖尿病足的发生。方法:396例诊断为2型糖尿病患者分为非糖尿病足组(NDF)353例及糖尿病足组(DF)43例,入选患者均进行ABI及血hs-CRP检测,同时选择30例常规体检正常者作为对照组,分析不同ABI组糖尿病足患病率的差异,观察血hs-CRP与糖尿病及糖尿病足患者病情预后的相关性。结果:ABI与DF患病率呈类似鱼钩状分布的关系,不同ABI组间患病率有显著性差异,差异有统计学意义(P<0.05);糖尿病组与正常对照组比较血hs-CRP,差异有统计学意义(P<0.05);DF组与NDF组比较血hs-CRP,差异亦有统计学意义(P<0.05)。结论:ABI与DF的发生有着明显的相关性,ABI降低或异常升高对DF的发生有早期预测作用;DF患者病情及预后与血hs-CRP呈正相关性,血hs-CRP测定对DF感染患者诊断及其转归可作为敏感指标,亦对DF的炎症水平预后指标有肯定评价作用;对有ABI异常且血hs-CRP明显升高的糖尿病高危患者应及早、积极采取有效的干预措施,且对于临床症状非典型患者更有临床意义。

objective To assess the correlations between ankle brachial index （ ABI）,blood high sensitivity C-reactive protein（ hs-CRP）,the incidence and prognosis of diabetic foot（ DF）,in order to identify the related risk factors and take effective measures early to pre-vent DF from happening. Method The ABI and blood hs-CRP level of 353 diabetic patients without DF,43 diabetic patients with DF,and 30 healthy subjects were tested,then the differences between incidences of the diabetic patients with DF were analyzed,and the correlations be-tween blood hs-CRP and prognosis of DF were observed. Results The correlations between ABI and the incidence of DF had a distribution that looked like a fishhook. The differences between the incidences of the diabetic patients with DF were significant（P〈0. 05）. The blood hs-CRP level between diabetic patients and healthy subjects were significant（P〈0. 05）. The blood hs-CRP level between diabetic patients with DF and diabetic patients without DF were significant（P〈0. 05）. Conclusion The ABI is closely associated with incidence of DF,the decrease and increase of ABI is useful to the prediction of the DF incidence. The pathogenetic condition and prognosis of DF in diabetic pa-tients has positive correlation with the blood hs-CRP level,and blood hs-CRP level has the high diagnosis value,may take the sensitive in-dex uses in the diagnosis and treatment of DF. The diabetic patients with abnormal ABI and increased blood hs-CRP should be taken effec-tive measures early to prevent DF from happening.