Ahmet Karakas, Assistant Professor, Department of Infectious Disease and Clinical Microbiology, Gulhane Military Medical Academy and School of Medicine, Ankara, Turkey.
Dr. Erol Arslan, Assistant Professor, Department of Medicine, Gulhane Military Medical Academy and School of Medicine, Ankara, Turkey.
Pak J Med Sci. 2014 May;30(3):578-82. doi: 10.12669/pjms.303.4575.
The aim of this pilot study was to determine clinical and laboratory factors that predict amputation surgery and to evaluate the predictive value of soluble CD14 (sCD14), interleukin-6 (IL-6), and procalcitonin (PCT) in patients with diabetic foot ulcers (DFUs).
Twenty-seven (20 males, 7 females) Diabetic Foot Ulcers (DFU) patients admitted to our department were consecutively enrolled. The patients' demographics and wound characteristics were noted. IL-6, PCT, and sCD14 were measured at admission.
Six of the 27 patients (22%) eventually underwent lower extremity amputation. Compared to the non-amputation group, a previous history of amputation (p=0.017), the presence of gangrene (p=0.044), the Wagner grade (p=0.011), the IL-6 concentration (p=0.018), the white blood cell count (WBC) (p=0.036), and the erythrocyte sedimentation rate (ESR) (p=0.042) were significantly high in the amputation group. However, the sCD14 and PCT concentration were not significantly different.
We have shown for the first time that IL-6 may have predictive value for lower extremity amputation in patients with DFU. Further studies are needed to confirm its predictive value in this patient group.
本初步研究旨在确定预测截肢手术的临床和实验室因素，并评估可溶性 CD14（sCD14）、白细胞介素-6（IL-6）和降钙素原（PCT）在糖尿病足溃疡（DFU）患者中的预测价值。
连续纳入 27 名（20 名男性，7 名女性）患有糖尿病足溃疡（DFU）的患者到我科。记录患者的人口统计学和伤口特征。入院时测量 IL-6、PCT 和 sCD14。
27 名患者中有 6 名（22%）最终进行了下肢截肢。与非截肢组相比，既往截肢史（p=0.017）、坏疽存在（p=0.044）、Wagner 分级（p=0.011）、IL-6 浓度（p=0.018）、白细胞计数（WBC）（p=0.036）和红细胞沉降率（ESR）（p=0.042）在截肢组中显著升高。然而，sCD14 和 PCT 浓度没有显著差异。
我们首次表明，IL-6 可能对 DFU 患者的下肢截肢具有预测价值。需要进一步的研究来证实其在该患者群体中的预测价值。
