血清MMP-3、HBD-3水平与糖尿病足感染严重程度、预后的关系

Relationship between serum MMP-3,HBD-3 levels and the severity and prognosis of diabetic foot infection

目的探究血清基质金属蛋白酶-3(MMP-3)、人β-防御素-3(HBD-3)水平与糖尿病足感染严重程度、预后的关系。方法选择石家庄市中医院2020年8月至2022年8月收治的糖尿病足感染患者116例作为研究组,依据病情感染程度,分为轻度组(n=38)、中度组(n=51)、重度组(n=27);根据随访结果,分为预后良好组(n=74)、预后不良组(n=42);另选取在本院就诊的未发生感染的糖尿病足患者116例作为对照组。采用ELISA法检测血清MMP-3、HBD-3水平;多因素logistic回归分析糖尿病足感染患者预后的影响因素;ROC曲线分析血清MMP-3、HBD-3对预后的预测效能。结果研究组血清MMP-3水平均显著高于对照组,血清HBD-3水平均显著低于对照组,且重度组血清MMP-3水平均显著高于轻度组、中度组及对照组,中度组血清MMP-3水平均高于轻度组、对照组,而重度组血清HBD-3水平均显著低于轻度组、中度组及对照组,中度组血清HBD-3水平均显著低于轻度组、对照组(均P<0.05);预后不良组血清MMP-3水平均显著高于预后良好组,而血清HBD-3水平显著低于预后良好组(均P<0.05);血清MMP-3、HBD-3为糖尿病足感染患者预后的影响因素(P<0.05);血清MMP-3、HBD-3联合应用预测糖尿病足感染患者预后的曲线下面积(AUC)为0.944,优于各单项检测(Z二者联合-MMP-3=2.172、Z二者联合-HBD-3=2.979,P=0.030、P=0.003)。结论糖尿病足感染患者血清MMP-3显著升高,血清HBD-3水平显著降低,且与患者病情严重程度、预后紧密相关,二者联合应用对糖尿病足感染患者预后有更高的预测效能。

ObjectiveTo explore the relationship between serum levels of matrix metalloproteinase-3(MMP-3)and human beta-defensin-3(HBD-3)and the severity and prognosis of diabetic foot infection.MethodsFrom August 2020 to August 2022,116 patients with diabetic foot infection accepted by Shijiazhuang Traditional Chinese Medicine Hospital were regarded as the study group,according to the degree of infection,they were separated into mild group(n=38),moderate group(n=51),and severe group(n=27);according to the follow-up results,the patients were separated into a good prognosis group(n=74)and a poor prognosis group(n=42);in addition,116 patients with simple diabetic foot were regarded as control group.ELISA was applied to detect the levels of MMP-3 and HBD-3 in serum;multivariate Logistic regression was applied to analyze the prognostic factors of patients with diabetic foot infection;ROC curve was applied to analyze the predictive efficacy of serum MMP-3 and HBD-3 for prognosis.ResultsThe serum MMP-3 expression level in the study group was obviously higher than that in the control group,and the serum HBD-3 expression level was obviously lower than that in the control group,the serum MMP-3 expression level in the severe group was obviously higher than that in the mild,moderate groups and control group,and the serum MMP-3 expression level in the moderate group was higher than that in the mild group and control group,the serum HBD-3 expression level in the severe group was obviously lower than that in the mild,moderate groups and control group,and the serum HBD-3 expression level in the moderate group was obviously lower than that in the mild group and control group(all P<0.05);the serum MMP-3 level in the poor prognosis group was obviously higher than that in the good prognosis group,while the serum HBD-3 level was obviously lower than that in the good prognosis group(all P<0.05);serum MMP-3 and HBD-3 were the prognostic factors in patients with diabetic foot infection(P<0.05);the area under the curve(AUC)of serum MMP-3 combined HBD-3 in predicting the prognosis of patients with diabetic foot infection was 0.944,which was better than their separate detection(Z combination-MMP-3=2.172,Z combination-HBD-3=2.979,P=0.030,P=0.003).ConclusionThe serum MMP-3 level in patients with diabetic foot infection is obviously increased,and the serum HBD-3 expression level is obviously reduced,which is closely related to the severity of condition and prognosis.The combination of both indicators has a higher predictive effect on the prognosis of patients with diabetic foot infection.