ICAM-1、VCAM-1在糖尿病足患者病程分级中的应用价值分析

The application value of ICAM-1 and VCAM-1 in the classification of diabetic foot patients

目的探究细胞黏附因子1(ICAM-1)、血管内皮细胞黏附因子1(VCAM-1)在糖尿病足患者病程分级中的应用价值。方法选择2017年7月—2020年2月本院收治的86例糖尿病足患者作为研究对象,按Wagner分级将其分为1级组(30例)、2级组(28例)和3级组(28例),比较三组患者血流变水平以及血管黏附因子水平,并就血流变与黏附因子之间的相关性进行分析。结果比较显示2级患者的低切黏度、血浆比黏度均高于1级患者(P<0.05);3级患者低切黏度、血小板聚集指数和血浆比黏度高于1级和2级患者,高切黏度明显高于1级患者(P<0.05);比较显示2级患者ICAM-1和VCAM-1水平高于1级,3级高于2级,组间比较差异明显(P<0.05);相关性分析显示ICAM-1同低切黏度、血浆比黏度呈正相关,VCAM-1同低切黏度、血小板聚集指数和血浆比黏度呈正相关(P<0.05)。结论糖尿病足患者存在较为明显的血流变和黏附因子异常,且与病程分级呈现相关性,推测其共同参与了糖尿病足的病程发展。

Objective To explore the application value of cell adhesion factor 1(ICAM-1)and vascular endothelial cell adhesion factor 1(VCAM-1)in the classification of the course of diabetic foot patients.Methods 86 patients with diabetic foot who were treated in our hospital from July 2017 to February 2020 were selected as the research object,and after Wagner classification,they were divided into grade 1 group(30 cases)and grade 2 group(28 Cases)and the level 3 group(28 cases),compared the hemorheology and vascular adhesion factor levels of the three groups,and analyzed the correlation between blood rheology and adhesion factors.Results Result of comparison showed that the low-cut viscosity and plasma specific viscosity of grade 2 patients were higher than those of grade 1(P<0.05).The low-cut viscosity,platelet aggregation index and plasma specific viscosity of grade 3 patients were higher than those of grade 1 and 2 grade 2 patients,however,the high-cut viscosity was significantly higher than grade 1 patients(P<0.05).Comparison shows that grade 2 patients had higher levels of ICAM-1 and VCAM-1 than grade 1 patients,those of grade 3 patients were higher than that of grade 2 patients,and the differences within groups was statistically significant(P<0.05).Correlation analysis showed that ICAM-1 was positively correlated with low shear viscosity and plasma specific viscosity,VCAM-1 was positively correlated with low shear viscosity,platelet aggregation index and plasma specific viscosity(P<0.05).Conclusions Patients with diabetic foot present obvious hemorheology and adhesion factor abnormalities.Hemorheology and adhesion were correlated with the grade of disease course.It is speculated that they jointly participate in the development of diabetic foot course.