D-二聚体和超敏C反应蛋白在2型糖尿病足早期临床诊断中的应用研究

Application research of D-dimer and high sensitive C reactive protein in early diagnosis of type 2 diabetic foot

目的探讨D-二聚体和超敏C反应蛋白在2型糖尿病足早期临床诊断中的应用效果。方法随机选取2016年5月~2018年5月我院门诊收治的88例疑似2型糖尿病患者作为糖尿病足组,根据患者的实际病情状况将其分为糖尿病组(n=37)、糖尿病足0级组(n=14)、糖尿病足1级组(n=19)、糖尿病足2级组(n=18)。再选取同期入院体检的34例受检者作为正常(NC)组。回顾性分析各组的一般资料,并检测各组的D-二聚体和超敏C反应蛋白水平。结果糖尿病足组与NC组的年龄、病程、吸烟史、高血压、血红蛋白(Hb)、D-二聚体、超敏C反应蛋白水平及24 h尿蛋白定量比较,差异有统计学意义(P<0.05)。Logistic回归分析结果显示,年龄、病程、D-二聚体、超敏C反应蛋白水平、24h尿蛋白定量均是糖尿病足的危险因素(P<0.05)。糖尿病足0级组、糖尿病足1级组、糖尿病足2级组患者的D-二聚体及超敏C反应蛋白水平均高于糖尿病组、NC组,差异有统计学意义(P<0.05);糖尿病组与NC组的D-二聚体及超敏C反应蛋白水平比较,差异无统计学意义(P>0.05)。结论年龄、病程、D-二聚体和超敏C反应蛋白水平升高是2型糖尿病足的危险因素,其中,D-二聚体和超敏C反应蛋白水平上升可有效判断为2型糖尿病足,提示D-二聚体、超敏C反应蛋白水平可作为糖尿病足的敏感指标。

Objective To investigate the application effect of D-dimer and high sensitive C reactive protein in early diagnosis of type 2 diabetic foot. Methods A total of 88 cases of patients suspected with type 2 diabetes admitted to our hospital from May 2016 to May 2018 were randomly selected as diabetic foot group. According to the actual condition of the patients,they were divided into diabetes group (n=37),diabetic foot level 0 group (n=14),diabetic foot level 1 group (n=19),and diabetic foot level 2 group (n=18). The 34 subjects who underwent the physical examination in our hospital during the same period were selected as the normal (NC) group. The general data of each group were retrospectively analyzed,and the D-dimer and high sensitive C-reactive protein levels of each group were examined. Results There were significant differences in the age,course of disease,smoking history,hypertension,hemoglobin (Hb),D-dimer,high sensitive C-reactive protein and 24 h urine protein quantitation between the diabetic foot group and the NC group (P<0.05). Logistic regression analysis showed that age,course of disease,D-dimer,high sensitive C-reactive protein level,and 24 h urine protein quantitation were risk factors for diabetic foot (P<0.05). The levels of D-dimer and high sensitive C-reactive protein in diabetic foot level 0 group,diabetic foot level 1 group and diabetic foot level 2 group were higher than those in diabetic group and NC group,with statistically significant differences (P<0.05). There were no significant differences in the D-dimer and high sensitive C-reactive protein levels between the diabetes group and the NC group (P>0.05). Conclusion The age,course of disease,D-dimer and high sensitive C-reactive protein levels are risk factors for type 2 diabetic foot. Among them,the increase of D-dimer and high sensitive C-reactive protein levels can be effectively judged as type 2 diabetic foot,which suggests that D-dimer and high sensitive C-reactive protein levels can be used as sensitive indicators of diabetic foot.