血清超敏C-反应蛋白和降钙素原与D-二聚体及纤维蛋白原在糖尿病足感染患者中的变化分析

Changes of serum high-sensitivity C-reactive protein,procalcitonin,D-dimer and fibrinogen in diabetic foot patients complicated with infections

目的观察血清超敏C-反应蛋白(hs-CRP)、降钙素原(PCT)、D-二聚体及纤维蛋白原在糖尿病足合并感染患者中的变化及其相关性,为糖尿病足感染的早期发现、早期预防提供参考。方法选取2014年5月-2016年5月糖尿病足患者159例,其中未感染患者71例,感染患者88例,其中轻度感染患者34例,中度感染患者33例,重度感染患者21例;采用免疫比浊法检测hs-CRP水平,酶联荧光分析检测PCT水平,全自动血凝分析仪检测纤维蛋白原、D-二聚体;比较各组患者hs-CRP、PCT、纤维蛋白原和D-二聚体水平差异。结果不同感染程度糖尿病足患者hs-CRP、PCT、纤维蛋白原和D-二聚体水平间存在显著性差异(P<0.05);轻度感染组、中度感染组和重度感染组hs-CRP、PCT、纤维蛋白原和D-二聚体水平均明显高于未感染组,并且随着感染程度的加重水平不断升高;无效患者hs-CRP、PCT、纤维蛋白原和D-二聚体水平显著高于治愈患者、好转患者(P<0.05);经Pearson检验,159例糖尿病足患者hs-CRP、PCT、纤维蛋白原和D-二聚体水平与患者性别、年龄以及糖尿病病程间均无相关性。血清炎性指标hs-CRP、PCT与纤溶指标纤维蛋白原和D-二聚体间存在显著相关性(P<0.05)。结论炎症和纤溶指标在糖尿病足患者感染发展中发挥着重要作用,hs-CRP、PCT、纤维蛋白原和D-二聚体可用于反映糖尿病足感染程度及治疗情况。

OBJECTIVE To observe the changes of serum high-sensitivity C-reactive protein （hs CRP）,procalcitonin （PCT）,D-dimer and fibrinogen in diabetic foot patients complicated with infections and analyze the correlation so as to provide guidance for early discovery and prevention of the infections in the diabetic foot patients.METHODS A total of 159 diabetic foot patients who were treated in the hospital from May 2014 to May 2016 were enrolled in the study,including 71 patients without infection and 88 patients with infections;there were 34 cases of mild infections,33 cases of moderate infections,and 21 cases of severe infections.The hs-CRP level was determined by using immunoturbidimetry,the PCT level was detected by enzyme-linked fluorescence method,and the fibrinogen and D-dimer were detected with the use of automatic hemagglutination analyzer.The levels of hs-CRP,PCT,fibrinogen,and D-dimer were observed and compared.RESULTS There was significant difference in the level of hs-CRP,PCT,fibrinogen,or D-dimer among the diabetic foot patients with different degrees of infection （P〈 0.05）;the levels of hs-CRP,PCT,fibrinogen,and D-dimer were significantly higher in the mild infection group,the moderate infection group,and the severe infection group than in the non-infection group,which were elevated with the increase of severity of infections.The levels of hs-CRP,PCT,fibrinogen,and D dimer of the ineffective patients were significantly higher than those of the cured and improved patients （P〈0.05）.The Pearson test showed that the levels of hs-CRP,PCT,fibrinogen,and D-dimer of the 159 diabetic foot patients were not associated with the gender,age,and course of diabetes mellitus.There was significantly correlation betweenthe serum inflammatory indicators hs-CRP,PCT and the fibrinolytic indexes fibrinogen and D-dimer （P 〈 0.05）.CONCLUSION Inflammation and fibrinolysis play important roles in the progression of the infection in the diabetic foot patients;the hs-CRP,PCT,fibrinogen and D-dimer can be used to reflect the degree of infections and treatment of diabetic foot.