Ardelean Andrei, Balta Diana-Federica, Neamtu Carmen, Neamtu Adriana Andreea, Rosu Mihai, Pilat Luminita, Moldovan Silviu, Tarta Cristi, Totolici Bogdan
1st Surgery Clinic, Faculty of Medicine, West University "Vasile Goldis" Arad, 310025 Arad, Romania.
Faculty of Medicine, West University "Vasile Goldis" Arad, 310025 Arad, Romania.
Diagnostics (Basel). 2023 Jul 13;13(14):2366. doi: 10.3390/diagnostics13142366.
Strategies have been researched and implemented to reduce the number of people with diabetic foot ulcers (DFUs). One problem is the accurate assessment of DFU severity, which is the main factor in resource allocation and treatment choice. The primary objective of this study was to assess pentraxin-3 as a biomarker of an infected DFU (IDFU), the limb amputation level prognosis, and patient survival. The secondary objectives were to evaluate and compare other markers, including white blood cells (WBCs), C-reactive protein (CRP), the erythrocyte sedimentation rate (ESR), and procalcitonin (PCT), for identifying IDFUs. Over a period of two years, 145 patients were followed; 131 of these were analyzed for this study. Pentraxin-3 was found to be a good predictor of death ( = 0.047). A comparison between IDFUs and DFUs revealed the following differences: PCT had the highest AUROC of 0.91, sensitivity of 93.7, and specificity of 83.3%. CRP had a cutoff value of 226 mg/L, an AUROC of 0.89, a sensitivity of 95.5%, and a specificity of 83.3%. Fibrinogen had an AUROC of 0.87 at a cutoff value of 5.29 g/L, with a good sensitivity and specificity of 85% and 87%, respectively. ESR had a cutoff value of 46 mm/h, an AUROC of 85%, a sensitivity of 83.7%, and a specificity of 83.3%. Pentraxin-3 showed promising results in predicting IDFUs and DFUs, and it served as a marker for the risk of death in IDFU patients during the 6 month follow-up. Other markers, including CRP, PCT, ESR, and fibrinogen, were more effective in differentiating between IDFUs and DFUs.
已经研究并实施了减少糖尿病足溃疡（DFU）患者数量的策略。一个问题是DFU严重程度的准确评估，这是资源分配和治疗选择的主要因素。本研究的主要目的是评估五聚体-3作为感染性DFU（IDFU）的生物标志物、肢体截肢水平预后和患者生存率。次要目的是评估和比较其他标志物，包括白细胞（WBC）、C反应蛋白（CRP）、红细胞沉降率（ESR）和降钙素原（PCT），以识别IDFU。在两年的时间里，对145名患者进行了随访；其中131名患者纳入本研究进行分析。发现五聚体-3是死亡的良好预测指标（P = 0.047）。IDFU与DFU之间的比较显示出以下差异：PCT的曲线下面积（AUROC）最高，为0.91，敏感性为93.7%，特异性为83.3%。CRP的临界值为226 mg/L，AUROC为0.89，敏感性为95.5%，特异性为83.3%。纤维蛋白原在临界值为5.29 g/L时AUROC为0.87，敏感性和特异性分别为85%和87%，表现良好。ESR的临界值为46 mm/h，AUROC为85%，敏感性为83.7%，特异性为83.3%。五聚体-3在预测IDFU和DFU方面显示出有前景的结果，并且在6个月的随访期间作为IDFU患者死亡风险的标志物。包括CRP、PCT、ESR和纤维蛋白原在内的其他标志物在区分IDFU和DFU方面更有效。
