糖尿病足患者血清VEGF、bFGF水平与下肢血管病变程度的关系

Relationships between the levels of VEGF,bFGF and the degree of lower extremity vascular disease in diabetic foot.

目的研究糖尿病足患者血清血管内皮细胞生长因子(VEGF)、碱性成纤维细胞生长因子(bFGF)水平与下肢血管病变程度的关系。方法回顾性选择2018年9月至2020年12月马鞍山市中医院东院收治的糖尿病足患者98例为研究组,采用泛大西洋学会联盟(TASC)分型标准,根据患者下肢血管病变程度分为A级25例,B级37例,C级24例,D级12例,另取同期单纯糖尿病患者98例为对照组。收集所有患者实验室检查指标;采用酶联免疫吸附试验(ELISA)检测所有受试者血清VEGF、bFGF水平;采用Pearson法分析血清VEGF、bFGF水平与下肢动脉病变评分、踝肱指数(ABI)及趾肱指数(TBI)水平的相关性。结果与对照组比较,研究组患者空腹血糖、外周血中性粒细胞比率、白细胞计数、糖化血红蛋白水平及血清C反应蛋白水平显著增加,血清VEGF、bFGF水平显著降低,差异均有统计学意义(P<0.05)。A级、B级、C级、D级糖尿病足患者下肢动脉病变评分依次升高,血清VEGF、bFGF水平、ABI、TBI水平均依次降低(P<0.05)。糖尿病足患者血清VEGF水平与bFGF、ABI、TBI水平呈正相关(r=0.624、0.425、0.626,P<0.001),与下肢动脉病变评分呈负相关(r=-0.568,P<0.001);血清bFGF水平与下肢动脉病变评分呈负相关(r=-0.564,P<0.001),与ABI、TBI水平呈正相关(r=0.413、0.655,P<0.001)。结论糖尿病足患者血清VEGF、bFGF水平显著降低,与下肢血管病变严重程度增加有关,可能对临床评价糖尿病足下肢血管病变程度有一定参考价值。

Objective To study the relationships between the levels of serum vascular endothelial growth factor(VEGF),basic fibroblast growth factor(bFGF)in diabetic foot and the degree of lower extremity vascular disease.Methods A total of 98 patients with diabetic foot admitted to East Hospital of Maanshan Hospital of Chinese Medicine from September 2018 to December 2020 were selected as the study group.According to the Trans-Atlantic Inter-Society Consensus(TASC),they were divided into 25 patients in grade A,37 in grade B,24 in grade C and 12 in grade D,another 98 patients with simple diabetes in the same period were selected as the control group.General data and clinical examination indexes of all patients were collected,the levels of VEGF and bFGF were detected by enzyme-linked immunosorbent assay(ELISA),Pearson's method was used to analyze the correlations between the levels of VEGF,bFGF in serum and the lower extremity arterial disease score,ankle brachial index(ABI),toe brachial index(TBI).Results Compared with the control group,fasting blood glucose,peripheral blood neutrophil ratio,white blood cell count,glycosylated hemoglobin level and serum C reactive protein level in the study group increased significantly,the levels of serum VEGF and bFGF were significantly reduced,and the differences were statistically significant(P<0.05).The lower extremity artery disease score of diabetic foot patients with grade A,B,C and D increased in turn,and the levels of serum VEGF,bFGF,ABI and TBI decreased in turn(P<0.05).The level of serum VEGF was positively correlated with bFGF,ABI,TBI levels in diabetic foot(r=0.624,0.425,0.626,P<0.001),and negatively correlated with lower extremity artery disease score(r=-0.568,P<0.001);the level of serum bFGF was negatively correlated with lower extremity artery disease score(r=-0.564,P<0.001),and positively correlated with ABI and TBI(r=0.413,0.655,P<0.001).Conclusion The levels of VEGF and bFGF in diabetic foot are significantly decreased,which is related to the increase of the severity of lower extremity vascular disease,and may has some reference value for clinical evaluation of the degree of lower extremity vascular disease of diabetic foot.