血清淀粉样蛋白A和载脂蛋白B/载脂蛋白A1比值在糖尿病足中的变化及意义

Changes and Significance of Serum Amyloid A and apoB/ApoA1 Ratio in Diabetic Foot

目的:分析血清淀粉样蛋白A(SAA)和载脂蛋白B/载脂蛋白A1比值(ApoB/ApoA1)在糖尿病足(DF)中的变化及意义。方法:选取262例2型糖尿病(DM)患者作为研究对象,按是否并发DF分为DF组(n=128)和DM组(n=134),另选取同期体检并无高血脂、肥胖等DM高危因素的健康者作为对照组(n=135),比较三组受试者周血SAA和ApoB/ApoA1指标的变化,分析SAA和ApoB/ApoA1与DM病程、HbA1c、FGB等指标是否是DF发生的独立危险因素,并探讨SAA和ApoB/ApoA1间相关性及其对DF发生的预测价值。结果:DF组DM病程明显长于DM组,两组间比较具有统计学意义(P<0.05);DF组外周血ApoB、FBG、HbA1c、SAA和ApoB/ApoA1水平明显高于DM组和对照组,三组间比较具有统计学差异(P<0.05)。Logistic线性回归分析:病程、FBG、HbA1c、SAA和ApoB/ApoA1是DF发生的独立危险因素。Pearson直线相关性分析结果显示:SAA与ApoB/ApoA1呈正相关(r=0.486,P<0.001)。外周血SAA和ApoB/ApoA1二者联合对DF的预测敏感性(85.52%)和特异性(89.30%)高于SAA或ApoB/ApoA1单独预测效能(P<0.05)。结论:外周血SAA和ApoB/ApoA1水平是DF发生的独立危险因素,对DF具有较好的预测价值,值得临床推广应用。

Objective:To analyze the changes and significance of serum amyloid A(SAA)and apolipoprotein B(ApoB)to apolipoprotein A1(ApoA1)(apoB/ApoA1)in diabetic foot(DF).Methods:262 patients with type 2 diabetes mellitus(DM)were selected as the study object.According to whether DF was complicated,they were divided into DF group(n=128)and DM group(n=134),healthy people without high risk factors of DM such as hyperlipidemia and obesity were selected as the control group(n=135).The changes of SAA and ApoB/ApoA1 in peripheral blood of three groups were compared.To analyze whether SAA,apoB/ApoA1,course of DM,HbA1c,FGB were independent risk factors for DF occurrence,and to explore the correlation between SAA and ApoB/ApoA1 and their predictive value for DF occurrence.Results:The course of DM in DF group was significantly longer than that in DM group(P<0.05),and the levels of ApoB,FBG,HbA1c,SAA and ApoB/ApoA1 in DF group were significantly higher than those in DM group and control group(P<0.05).Logistic multiple linear regression analysis show that course of DM,FBG,HbA1c,SAA and ApoB/ApoA1 were independent risk factors for DF.Pearson correlation analysis showed that SAA was positively correlated with ApoB/ApoA1(r=0.486,P<0.001).The prediction sensitivity(85.52%)and specificity(89.30%)of SAA and ApoB/ApoA1 were higher than that of SAA or ApoB/ApoA1 alone(P<0.05).Conclusion:SAA and ApoB/ApoA1 in peripheral blood are independent risk factors for DF,which have certain value for DF prediction.