Akinci Baris, Yener Serkan, Yesil Sena, Yapar Nur, Kucukyavas Yasin, Bayraktar Firat
Division of Endocrinology and Metabolism, Department of Internal Medicine, Dokuz Eylul University Medical School, Izmir, Turkey.
J Am Podiatr Med Assoc. 2011 Jan-Feb;101(1):1-6. doi: 10.7547/1010001.
prediction of amputation would aid clinicians in the management of diabetic foot infections. We aimed to assess the predictive value of baseline and post-treatment levels of acute phase reactants in the outcome of patients with diabetic foot infections.
we collected data prospectively during minimum follow-up of 6 months in patients with infected diabetic foot ulcers hospitalized in Dokuz Eylul University Hospital between January 1, 2003, and January 1, 2008. After excluding patients who did not attend the hospital for follow-up visits regularly (n = 36), we analyzed data from 165 foot ulcer episodes.
limb ischemia and osteomyelitis were much more frequent in patients who underwent amputation. Wagner grade, which assesses ulcer depth and the presence of osteomyelitis or gangrene, was higher in patients who needed amputation. Ulcer size was slightly larger in the amputation group. Baseline and post-treatment C-reactive protein levels, erythrocyte sedimentation rates, white blood cell counts, and platelet counts were significantly elevated in patients who underwent amputation. Albumin levels were significantly suppressed in the amputation group. Univariate analysis showed that a 1-SD increase in baseline and post-treatment C-reactive protein levels, erythrocyte sedimentation rates, and white blood cell counts and a 1-SD decrease in post-treatment albumin levels were significantly associated with increased risk of amputation. Post-treatment C-reactive protein level was strongly associated with amputation risk.
circulating levels of acute phase reactants were associated with amputation risk in diabetic foot infections.
截肢预测有助于临床医生管理糖尿病足感染。我们旨在评估急性期反应物的基线水平和治疗后水平对糖尿病足感染患者预后的预测价值。
我们前瞻性收集了2003年1月1日至2008年1月1日在多库兹艾吕尔大学医院住院的感染性糖尿病足溃疡患者至少6个月的随访数据。在排除未定期到医院随访的患者（n = 36）后，我们分析了165例足部溃疡发作的数据。
接受截肢的患者肢体缺血和骨髓炎更为常见。评估溃疡深度以及骨髓炎或坏疽情况的瓦格纳分级在需要截肢的患者中更高。截肢组的溃疡面积略大。接受截肢的患者基线和治疗后的C反应蛋白水平、红细胞沉降率、白细胞计数和血小板计数均显著升高。截肢组的白蛋白水平显著降低。单因素分析显示，基线和治疗后C反应蛋白水平、红细胞沉降率和白细胞计数每增加1个标准差，以及治疗后白蛋白水平每降低1个标准差，均与截肢风险增加显著相关。治疗后C反应蛋白水平与截肢风险密切相关。
急性期反应物的循环水平与糖尿病足感染的截肢风险相关。
