糖尿病足溃疡Wagner分级与炎性反应指标的关系

Relationship of Wagner grade of diabetic foot ulcer with inflammatory response index

目的探讨糖尿病足溃疡(DFU)Wagner分级与炎性反应指标的关系。方法收集2020年1月至2021年5月于北京中医药大学东直门医院住院治疗的106例DFU患者的临床资料,根据Wagner分级判断病变严重程度并将所有患者分为轻度病变组(n=32,Wagner分级<3级)和中重度病变组(n=74,Wagner分级≥3级)。分析DFU患者Wagner分级与炎性反应指标[外周血白细胞(WBC)、中性粒细胞百分比(NEUT%)、C反应蛋白(CRP)、红细胞沉降率(ESR)、降钙素原(PCT)及白细胞介素-6(IL-6)]的关系及DFU患者Wagner分级的影响因素。结果Wagner分级≥3级组患者的WBC、NEUT%、CRP水平、ESR水平、IL-6水平均高于Wagner分级<3级组患者,差异均有统计学意义(P<0.05)。两组患者的PCT水平比较,差异无统计学意义(P>0.05)。多因素分析结果显示,ESR、IL-6水平均是DFU患者Wagner分级的影响因素(P<0.05),模型拟合度良好(R2=0.447)。结论ESR、IL-6水平是DFU患者Wagner分级的影响因素,临床中可以结合DFU患者的Wagner分级及相关炎性反应指标进行综合分析与判断,有利于指导DFU的临床诊断及治疗。

Objective To explore the relationship of Wagner grade of diabetic foot ulcer(DFU)with inflammatory response index.Method The clinical data of 106 DFU patients hospitalized in Dongzhimen Hospital Beijing University of Chinese Medicine from January 2020 to May 2021 were collected.The severity of the lesion was determined according to Wagner grade,all patients were divided into mild pathological group(n=32,Wagner grade<3)and moderate and severe pathological group(n=74,Wagner grade≥3).The relationship between Wagner grade of DFU patients and inflammatory response indexes[peripheral white blood cell(WBC),neutrophil percentage(NEUT%),C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),procalcitonin(PCT)and interleukin-6(IL-6)],and the influencing factors of Wagner grade in DFU patients were analyzed.Result The WBC,NEUT%,CRP,ESR and IL-6 levels in Wagner grade≥3 group were higher than those in Wagner grade<3 group(P<0.05).There was no significant difference in PCT level between the two groups(P>0.05).Multivariate analysis showed that ESR and IL-6 levels were the influencing factors of Wagner grade in DFU patients(P<0.05),and the fitting degree of the model was good(R2=0.447).Conclusion ESR and IL-6 levels are the influencing factors of Wagner grade of DFU patients,and comprehensive analysis and judgment can be made by combining Wagner grade of DFU patients and related inflammatory response indexes in clinic,which is helpful for guiding clinical diagnosis and treatment of DFU.