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血清降钙素原、白细胞介素-6 和纤维蛋白原水平在糖尿病足溃疡感染鉴别诊断中的作用。

The Role of Serum Procalcitonin, Interleukin-6, and Fibrinogen Levels in Differential Diagnosis of Diabetic Foot Ulcer Infection.

机构信息

Department of Clinical Microbiology and Infectious Diseases, Dumlupınar University Faculty of Medicine, 43020 Kutahya, Turkey.

Department of Biochemistry, Dumlupınar University Faculty of Medicine, Kutahya, Turkey.

出版信息

J Diabetes Res. 2018 Feb 21;2018:7104352. doi: 10.1155/2018/7104352. eCollection 2018.

DOI:10.1155/2018/7104352
PMID:29675434
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5841040/
Abstract

AIMS

We aimed to evaluate the roles of interleukin-6 (IL-6), PCT, and fibrinogen levels in the differential diagnosis of the patients with infected diabetic foot ulcer (IDFU) and noninfected diabetic foot ulcer (NIDFU) and to compare those with C-reactive protein (CRP), white blood cell (WBC), and erythrocyte sedimentation rate (ESR).

METHODS

Patients over 18 years with a diagnosis of type 2 diabetes mellitus and DFU who were followed up in our hospital between 1 January 2016 and 1 January 2017 were included in the study. In addition to this patient group, patients with diabetes but without DFU were determined as the control group.

RESULTS

Thirty-eight patients with IDFU, 38 patients with NIDFU, and 43 patients as the control group were included in the study. Fifty-six point three percent of the patients who participated in the study were males, and the mean age was 61.07 ± 11.04 years. WBC, ESR, CRP, IL-6, and fibrinogen levels of the cases with IDFU were determined to be significantly higher compared to the cases in NIDFU ( < 0.01). The area under the ROC curve (AUROC) value was highest for CRP (0.998; < 0.001), and the best cut-off value for CRP was 28 m/L. The best cut-off values for fibrinogen, IL-6, ESR, and WBC were 480 mg/dL, 105.8 pg/mL, 31 mm/h, and 11.6 (103 /L), respectively.

CONCLUSION

Serum PCT levels were not found to be effective in the discrimination of IDFU and NIDFU. Serum IL-6 and fibrinogen levels seem to be two promising inflammatory markers in the discrimination of IDFU.

摘要

目的

评估白细胞介素-6(IL-6)、降钙素原(PCT)和纤维蛋白原水平在鉴别感染性糖尿病足溃疡(IDFU)和非感染性糖尿病足溃疡(NIDFU)患者中的作用,并将其与 C 反应蛋白(CRP)、白细胞(WBC)和红细胞沉降率(ESR)进行比较。

方法

纳入 2016 年 1 月 1 日至 2017 年 1 月 1 日期间在我院就诊的 18 岁以上的 2 型糖尿病合并 DFU 患者,并将这些患者分为病例组(IDFU 患者 38 例,NIDFU 患者 38 例),另选取同期在我院就诊的单纯糖尿病患者(无 DFU)为对照组(43 例)。

结果

共纳入 38 例 IDFU 患者、38 例 NIDFU 患者和 43 例对照组患者。男性占 56.3%,平均年龄为 61.07±11.04 岁。与 NIDFU 患者相比,IDFU 患者的 WBC、ESR、CRP、IL-6 和纤维蛋白原水平显著升高(<0.01)。CRP 的 ROC 曲线下面积(AUROC)最高(0.998;<0.001),最佳 CRP 截断值为 28 m/L。纤维蛋白原、IL-6、ESR 和 WBC 的最佳截断值分别为 480 mg/dL、105.8 pg/mL、31 mm/h 和 11.6×10^3/L。

结论

血清 PCT 水平在鉴别 IDFU 和 NIDFU 方面效果不佳。血清 IL-6 和纤维蛋白原水平似乎是鉴别 IDFU 的两个有前途的炎症标志物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a70b/5841040/e79c70964736/JDR2018-7104352.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a70b/5841040/e79c70964736/JDR2018-7104352.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a70b/5841040/e79c70964736/JDR2018-7104352.001.jpg

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The role of procalcitonin as a marker of diabetic foot ulcer infection.降钙素原作为糖尿病足溃疡感染标志物的作用。
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Brazilian Society of Angiology and Vascular Surgery 2023 guidelines on the diabetic foot.巴西血管病学与血管外科学会2023年糖尿病足指南
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