Top Cihan, Yildiz Senol, Oncül Oral, Qydedi Tauland, Cevikbaş Adile, Soyogul Umran Gurer, Cavuşlu Saban
Department of Internal Medicine, Gülhane Military Medical Academy, GATA Haydarpaşa Training Hospital, Tibbiye Cad. 81327 Haydarpaşa, Istanbul, Turkey.
J Infect. 2007 Oct;55(4):369-73. doi: 10.1016/j.jinf.2007.06.003. Epub 2007 Aug 2.
The aim of this study was to investigate changes in phagocytic activity of neutrophils of type 2 diabetic patients with foot infections over short treatment courses. The potential utility of the phagocytic index in determining the efficacy of treatment modalities and it's relationship with metabolic control parameters were evaluated.
The phagocytic activity of neutrophils was determined in blood samples of 38 type 2 diabetic patients with foot infections (14 women and 24 men). Mean age and mean duration of diabetes were 66.3+/-9.4 and 19.1+/-11.2 (yrs), respectively. All patients received standard treatment (intensive insulin therapy, antibiotherapy, hyperbaric oxygen therapy and surgical debridement). Phagocytic activity of neutrophils was determined by a standard method. Phagocytic activity of neutrophils, acute phase proteins (C-reactive protein) and glycosylated haemoglobin was determined before therapy and two weeks later.
The phagocytic index before and after therapy were 47.7+/-11.4 and 62.5+/-15.6, respectively (p<0.05). There was a significant correlation between phagocytic index and both CRP and HbA1c (r=0.52, p<0.05 and r=-0.41, p<0.05, respectively).
Derangement of carbohydrate metabolism may underlie the impairment of bactericidal activity of neutrophils of poorly controlled diabetic patients. These data reveal that phagocytic activity improves during short-course standard therapy and might enable monitoring of efficacy of treatment modalities in diabetic patients with foot infections.
本研究旨在调查2型糖尿病足感染患者在短疗程治疗期间中性粒细胞吞噬活性的变化。评估吞噬指数在确定治疗方式疗效方面的潜在效用及其与代谢控制参数的关系。
测定38例2型糖尿病足感染患者（14名女性和24名男性）血样中的中性粒细胞吞噬活性。糖尿病平均年龄和平均病程分别为66.3±9.4岁和19.1±11.2年。所有患者均接受标准治疗（强化胰岛素治疗、抗生素治疗、高压氧治疗和手术清创）。中性粒细胞吞噬活性采用标准方法测定。在治疗前和两周后测定中性粒细胞吞噬活性、急性期蛋白（C反应蛋白）和糖化血红蛋白。
治疗前后吞噬指数分别为47.7±11.4和62.5±15.6（p<0.05）。吞噬指数与CRP和HbA1c均存在显著相关性（分别为r=0.52，p<0.05和r=-0.41，p<0.05）。
碳水化合物代谢紊乱可能是糖尿病控制不佳患者中性粒细胞杀菌活性受损的原因。这些数据表明，在短疗程标准治疗期间吞噬活性有所改善，这可能有助于监测糖尿病足感染患者治疗方式的疗效。
