超声造影定量参数PI比值在糖尿病足溃疡组织存活性判断中的应用价值

Application Value of Quantitative Parameter PI Ratio of Contrastenhanced Ultrasound in Determining the Survival Activity of Diabetic Foot Ulcer Tissue

目的探讨超声造影(contrast-enhanced ultrasound,CEUS)定量参数PI比值在糖尿病足溃疡边缘组织存活性判断中的应用价值。方法选取2021年1—12月成都中医药大学附属医院收治的糖尿病足溃疡患者52例作为研究对象,采集患者的一般临床资料、相关实验室数据及超声造影定量分析数据。根据溃疡边缘组织生长情况分为存活组(34例)和坏死组(18例)。采用单因素分析及多因素Logistic回归筛选与溃疡愈合相关的因素,分析两组PI比值对于糖尿病足溃疡边缘存活的比值比(odds ratio,OR)。通过受试者工作曲线(receiver operating curve,ROC)分析PI比值对糖尿病足溃疡存活性判断的预测效能和最佳截断值。结果存活组与坏死组年龄、空腹血糖和糖化血红蛋白(HbA1c)比较,差异有统计学意义(P<0.05);存活组超声造影PI比值(0.74±0.15)高于坏死组(0.53±0.14),差异有统计学意义(P<0.001)。多因素Logistic回归分析显示PI比值[OR=10.012,95%CI(7.048~15.224)]、HbA1c[OR=0.856,95%CI(0.758~0.895)]和年龄[OR=0.912,95%CI(0.815~0.954)]是糖尿病足患者溃疡边缘存活的独立影响因素(P<0.05)。PI比值在糖尿病足溃疡患者中预测组织存活的最大曲线下面积(area under curve,AUC)为0.881,敏感度为94.1%,特异度为72.2%,最佳截断值为0.59。结论超声造影定量参数PI比值可用于预测糖尿病足溃疡边缘组织存活性,比值越高反映组织存活的可能性越大,可为临床决策提供客观化依据。

Objective To investigate the application value of PI ratio of quantitative parameter of contrast-enhanced ultrasound(CEUS)in determining the survival activity of diabetic foot ulcer tissue.Methods From January to December 2021,52 patients with diabetic foot ulcer admitted to Affiliated Hospital of Chengdu University of Traditional Chinese Medicine were selected as the study subjects.General clinical data,related laboratory data and quantitative analysis data of contrast-enhanced ultrasound were collected.According to the growth of ulcer marginal tissue,they were divided into survival group(34 cases)and necrotic group(18 cases).Factors related to ulcer healing were screened by univariate analysis and multivariate Logistic regression,and the odds ratio(OR)of PI ratio between the two groups for marginal survival of diabetic foot ulcers were analyzed.According to receiver operating curve(ROC),the predictive efficiency and optimal cut-off value of PI ratio for survival of diabetic foot ulcer were analyzed.Results Compared with the age,fasting blood glucose and HbA1c between survival group and necrosis group,the difference was statistically significant(P<0.05);the ratio of PI in the survival group(0.74±0.15)was higher than that in the necrosis group(0.53±0.14),and the difference was statistically significant(P<0.001).Multivariate Logistic regression analysis showed that PI ratio[OR=10.012,95%CI(7.048-15.224)],HbA1c[OR=0.856,95%CI(0.758-0.895)]and age[OR=0.912,95%CI(0.815-0.954)]were independent factors influencing ulcer margin survival in diabetic foot patients(P<0.05).The maximum area under curve(AUC)for predicting tissue survival in diabetic foot ulcer patients was 0.881,the sensitivity was 94.1%,the specificity was 72.2%,and the optimal cutoff value was 0.59.Conclusion The ratio of PI,a quantitative parameter of contrast enhanced ultrasound,can be used to predict the survival activity of the marginal tissue of diabetic foot ulcer.The higher the ratio,the higher the probability of tissue survival,can provide an objective basis for clinical decision-making.