Unit of Vascular Surgery, Bianchi-Melacrino-Morelli Hospital, Reggio Calabria, Italy.
Cardiovascular and Thoracic Department, Policlinico G. Martino Hospital, University of Messina, Messina, Italy.
Int Wound J. 2017 Feb;14(1):31-34. doi: 10.1111/iwj.12536. Epub 2015 Oct 28.
Foot ulcers are frequent in diabetic patients and are responsible for 85% of amputations, especially in the presence of infection. The diagnosis of diabetic foot ulcer infection is essentially based on clinical evaluation, but laboratory parameters such as erythrocyte sedimentation rate (ESR), white blood count (WBC), C-reactive protein (CRP) and, more recently, procalcitonin (PCT) could aid the diagnosis, especially when clinical signs are misleading. Fifteen diabetic patients with infected foot ulcers were admitted to our department and were compared with an additional group of patients with non-infected diabetic foot ulcers (NIDFUs). Blood samples were collected from all patients in order to evaluate laboratory markers. In the current study, the diagnostic accuracy of PCT serum levels was evaluated in comparison with other inflammatory markers such as CRP, ESR and WBC as an indicator to make the distinction between infected diabetic foot ulcers (IDFUs) and NIDFUs. CRP, WBC, ESR and especially PCT measurements represent effective biomarkers in the diagnosis of foot infections in diabetic patients particularly when clinical signs are misleading.
足部溃疡在糖尿病患者中很常见，是导致 85%截肢的原因，尤其是在感染的情况下。糖尿病足溃疡感染的诊断主要基于临床评估，但红细胞沉降率（ESR）、白细胞计数（WBC）、C 反应蛋白（CRP）等实验室参数以及最近的降钙素原（PCT）等指标可以辅助诊断，尤其是在临床症状具有误导性时。我们科室收治了 15 例患有感染性足部溃疡的糖尿病患者，并与另一组患有非感染性糖尿病足部溃疡（NIDFUs）的患者进行了比较。所有患者均采集血样以评估实验室标志物。在本研究中，与 CRP、ESR 和 WBC 等其他炎症标志物相比，评估了 PCT 血清水平的诊断准确性，作为区分感染性糖尿病足溃疡（IDFUs）和 NIDFUs 的指标。CRP、WBC、ESR 特别是 PCT 测量值是糖尿病患者足部感染诊断的有效生物标志物，尤其是在临床症状具有误导性时。
