CD64与糖尿病足溃疡Wagner分级水平的关系

Relationship between CD64 and Wagner Grade of Diabetic Foot Ulcer

[目的]探讨外周血CD64水平与糖尿病足Wagner分级水平的关系.[方法]选取2017年11月至2018年12月因糖尿病足在本院诊治的162例患者,按照糖尿病足的Wagner分级(严重程度)分为两组:Wagner 2~3级(93例,A组)、Wagner 4~5级(69例,B组),比较两组外周血CD64、血清降钙素原(PCT)、C反应蛋白(CRP)及白细胞(WBC)水平,分析外周血CD64与其他指标的相关性;采用Logistic回归分析CD64和糖尿病足Wagner分级水平的关系.绘制ROC曲线,计算曲线下面积,分析CD64对糖尿病足严重程度预测的敏感性和特异性.[结果]A组患者CD64、CRP、PCT、WBC水平显著高于B组(P<0.05).相关性分析显示:外周血CD64与CRP、PCT、WBC水平正相关(r值分别为0.86,0.84,0.62;均P<0.05).多因素Logistic回归分析:糖尿病足病程、CD64、吸烟是糖尿病足病严重程度的独立危险因素(均P<0.05).ROC曲线下面积(0.892)显示,CD64与糖尿病足严重程度相关,根据Youden指数最大法,当CD64的取临界值是3.38,其敏感性是81.2%,特异性是91.4%.[结论]CD64与糖尿病足Wagner分级水平相关,高CD64表达水平提示糖尿病足的病情更严重.

[Objective]To explore the relationship between peripheral blood CD64 level and Wagner grading level of diabetic foot.[Methods]From November 2017 to December 2018,162 patients with diabetic foot were divided into two groups according to the Wagner classification(severity):Wagner 2‐3(93 cases,group A),Wagner 4‐5(69 cases,group B).The levels of peripheral blood CD64,serum procalcitonin(PCT),C‐reactive protein(CRP)and leukocyte(WBC)were compared between the two groups,The correlation between peripheral blood CD64 and other indexes was analyzed,and the relationship between CD64 and Wagner grade of diabetic foot was analyzed by logistic regression.The ROC curve was drawn,the area under the curve was calculated,and the sensitivity and specificity of CD64 in predicting the severity of diabetic foot were analyzed[Results]The levels of CD64,CRP,PCT and WBC in the group A were significantly higher than those in the group B(P<00.5).The correlation analysis showed that CD64 was positively correlated with CRP,PCT and WBC(r=08.6,08.4,06.2,respectively;P<00.5).Multivariate logistic regression analysis:the course of diabetic foot,CD64 and smoking were independent risk factors for the severity of diabetic foot disease(P<00.5).The area under ROC curve(08.92)showed that CD64 was related to the severity of diabetic foot.According to the maximum Youden index,when the critical value of CD64 was 33.8,its sensitivity was 812.%,and its specificity was 914.%[Conclusion]CD64 is related to Wagner's grade of diabetic foot,and high expression level of CD64 indicates that the condition of diabetic foot is more serious.