血清胱抑素C在介入治疗糖尿病足中的意义

Cystatin C as a marker to evaluated the endovasclaur surgery for diabetic foot

目的:探讨胱抑素C(Cys C)在糖尿病足发病及介入手术术后的意义。方法:选取2014年1月至2015年4月期间来我院就诊的糖尿病足患者40例(糖尿病足组),单纯糖尿病患者40例(单纯组),健康体检者40例(正常组);术前抽血检测患者血清胱抑素C(Cys C)、C-反应蛋白(C-RP)水平;糖尿病足组患者于术后第1、3、7天复查血清胱抑素C、C-反应蛋白水平及踝肱指数(ABI)。结果:术前正常组、单纯组与糖尿病足组血清Cys C和C-RP平均水平存在差异,差异有统计学意义(P <0. 05)。32例糖尿病足患者成功开通闭塞血管。糖尿病足组患者术后第1、3、7天血清Cys C、C-RP水平均呈先升高后降低趋势,各时间点两者水平均存在差异,差异有统计学意义(P <0. 008 3)。术后随访24月中,前12个月再次返院治疗者13例,后12个月再次返院治疗者16例;回顾性分析两组患者术前Cys C水平,前者较后平均水平要高,差异有统计学意义(P <0. 05)。结论:血清胱抑素C可能是糖尿病足的一项独立危险因素与预后的一项指标,可以作为糖尿病足介入手术疗效的评价指标。

Objective:To explore the role of cystatin C(CysC)in the physiopathology and prognostic after endovascualr operation in diabetic foot.Methods:120 patients including the outpatients and hospitalized between January 1st 2014 and April 30th 2015 were divided into three groups:patients with diabetic foot(diabetic group),patients with diabetes only(single group),physical examination(normal group),and 40 cases in each group respectively.All patients were to test the ankle brachial index(ABI),the value of serum CysC,Creactive protein(CRP)before endovascular surgery.The serum value of CysC and CRP on postoperative 1 d,3 d and 7 d were tested in diabetic foot group,and the ABI reexamination at the time of hospital discharge.Results:The value of the serum CysC,CRP and ABI at preoperative have a statistically difference(P<0.05)among the three groups,and the diabetic foot group highest of CysC,CRP and lowest of ABI.Thirty two patients were treated with endovascular successfully.To compare with preoperative score,values of CysC,CRP on postoperative 1d,3d are higher(P<0.008 3)and lower of 7d(P<0.008 3),and ABI higher(P<0.0083).32 patients were fellowed up for 24 months.Thirteen patients(within 1~12 months)and sixteen patients(within 12~24 months)relapsed and were back to hospital.Retrospective analysis the value of serum CysC of the two groups patients,there was a statistical difference(P<0.05).Conclusion:CysC may be an independent risk factor for diabetic foot and a prognostic marker of diabetic foot,it could also be a factor for evaluating the effective of endovascluar surgery.