血清UA、HMGB1、UAT预测糖尿病伴下肢ASO患者预后的临床价值

Clinical value of serum UA,HMGB1 and UAT in predicting the prognosis in patients with diabetes and lower extremity ASO

目的探究血清尿酸(UA)、高迁移率族蛋白B1(HMGB1)及尿酸盐转运蛋白(UAT)水平预测糖尿病伴下肢动脉硬化闭塞症(ASO)患者预后的临床价值。方法选择2016年9月至2019年9月该院收治的243例糖尿病伴下肢ASO患者,根据预后情况(药物涂层球囊治疗后随访12个月下肢血管再狭窄发生情况)分为预后好组(182例,未发生下肢血管再狭窄)与预后差组(61例,发生下肢血管再狭窄),比较两组血清UA、HMGB1及UAT水平,用Spearman相关分析血清UA、HMGB1及UAT水平与糖尿病伴下肢ASO患者预后的相关性,用Logistic回归分析分析糖尿病伴下肢ASO患者预后的影响因素,用受试者工作特征(ROC)曲线分析血清UA、HMGB1及UAT 3项联合检测预测糖尿病伴下肢ASO患者预后的临床价值。结果预后差组血清UA、HMGB1水平明显高于预后好组(P<0.05);预后差组血清UAT水平明显低于预后好组(P<0.05);血清UA、HMGB1水平与糖尿病伴下肢ASO患者预后差呈正相关(r=0.651、0.606,P<0.05);血清UAT水平与糖尿病伴下肢ASO患者预后差呈负相关(r=-0.589,P<0.05);血清UA、HMGB1水平上升及UAT水平下降是糖尿病伴下肢ASO患者预后的危险因素(P<0.05);血清UA、HMGB1及UAT水平3项联合检测预测糖尿病伴下肢ASO患者预后的ROC曲线下面积(AUC)为0.942(95%CI:0.907~0.977),灵敏度为83.60%,特异度为98.00%。结论血清UA、HMGB1及UAT水平与糖尿病伴下肢ASO患者预后关系密切,3项指标联合检测对糖尿病伴下肢ASO患者预后有较高的预测价值,有助于临床制订应对性干预措施,从而改善患者预后。

Objective To investigate the clinical value of serum uric acid(UA),high mobility group protein B1(HMGB1)and urate transporter(UAT)levels in predicting the prognosis of diabetic patients with lower extremity arteriosclerosis obliterans(ASO).Methods A total of 243 diabetic patients with lower extremity ASO in the hospital from September 2016 to September 2019 were enrolled.According to the prognosis(the incidence of lower extremity vascular restenosis after 12 months of follow-up after drug coated balloon treatment),they were divided into good prognosis group(128 cases,without lower extremity vascular restenosis)and poor prognosis group(61 cases,with lower extremity vascular restenosis).Serum UA,HMGB1 and UAT levels were compared between groups.Spearman correlation analysis was used to analyze the correlation between serum UA,HMGB1 and UAT levels and the prognosis of diabetic patients with lower extremity ASO.Logistic regression was used to analyze the factors influencing the prognosis of diabetic patients with lower extremity ASO,and the receiver operating characteristic(ROC)curve was used to analyze the clinical value of serum UA,HMGB1 and UAT levels in predicting the prognosis of diabetic patients with lower extremity ASO.Results Serum UA and HMGB1 levels in poor prognosis group were significantly higher than those in good prognosis group(P<0.05).Serum UAT levels in poor prognosis group were significantly lower than those in good prognosis group(P<0.05).The poor prognosis of diabetic patients with lower extremity ASO was positively correlated with serum UA and HMGB1 levels(r=0.651,0.606,P<0.05),and was negatively correlated with serum UAT level(r=-0.589,P<0.05).The increase in serum UA and HMGB1 levels and the decrease in UAT levels were risk factors for the prognosis of diabetic patients with lower extremity ASO(P<0.05).The area under ROC curve(AUC),sensitivity and specificity of combined defection of serum UA,HMGB1 and UAT in predicting the prognosis of diabetic patients with lower extremity ASO were 0.942(95%CI:0.907-0.977),83.60%and 98.00%.Conclusion Serum UA,HMGB1 and UAT levels are closely related to the prognosis of diabetic patients with lower extremity ASO who underwent DCB treatment,and the three indicators have high prognostic value for patients,which can provide clinical basis of intervention measures,thereby improving the prognosis status.