CD64指数对糖尿病足截趾风险的预测价值

Predictive Value of CD64 in Amputation Risk of Patients with Diabetic Foot

目的探讨外周血CD64指数对糖尿病足截趾风险的预测价值。方法研究对象选取2017年10月~2018年8月因糖尿病足住院的121例患者,采集临床资料,包括糖尿病足病程、血糖、血脂、糖化血红蛋白、踝肱指数、糖尿病并发症及合并症等,根据截趾情况分为未截趾组(n=89)和截趾组(n=32),比较两组外周血CD64、降钙素原(PCT)、C反应蛋白(CRP)及白细胞计数(WBC)水平,及CD64和PCT、CRP、WBC的相关性;采用Logistic回归分析对CD64指数对糖尿病足截趾的价值进行分析;绘制ROC曲线并计算曲线下面积来说明对于截趾风险的预测价值。结果截趾组患者CD64指数、CRP、PCT、WBC显著高于未截趾组(P<0.05)。相关性分析显示,外周血CD64指数与PCT、CRP、WBC水平呈正相关(r值分别为0.894、0.921、0.753,P均<0.01)。多因素Logistic回归分析显示,踝肱指数、CD64是糖尿病足截趾的独立危险因素(P均<0.05)。ROC分析显示,以外周血CD64指数为2.68作为糖尿病足截趾界限时,敏感度和特异性分别为87.5%和83.1%,ROC曲线下面积为0.925。结论CD64指数是糖尿病足截趾风险预测的良好指标。

Objective To investigate the predictive value of CD64 for the risk of amputation in patients with diabetic foot.Methods From October 2017 to August 2018,a total of 121 patients with diabetic foot were enrolled.The clinical data of patients were collected,including duration,serum glucose,blood lipid,glycated hemoglobin,ankle brachial index and complications of diabetes.The patients were divided into two groups,including non-amputation group(89 cases)and amputation group(32 cases).CD64,CRP,PCT,and WBC were compared.The rgression analysis was used to investigate the value of CD64 in toe amputation of diabetic foot.ROC urve was generated and AUC was calculated to compare the predictability of CD64 for amputation.Results CD64,CRP,PCT,and WBC in the amputation group were significantly higher than those of non-amputation group(all P<0.05).Two group of CD64,CRP,PCT and WBC were positively correlated(all P<0.05).In multiariable Logistic regression analysis,CD64 and ABI were independent risk factors.When the CD64 was 2.68 as the toe-amputation limit of diabetic foot,ROC analysis showed that the sensitivity and specificity were 87.5%and 83.1%respectively,and the ROC area was 0.925.Conclusion CD64 index is a good index for predicting the risk of toe amputation in diabetic foot.