Department of Peripheral Vascular, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China.
Immun Inflamm Dis. 2024 Apr;12(4):e1233. doi: 10.1002/iid3.1233.
To observe the expression of inflammatory factors and autophagy-related proteins in granulation tissue of diabetic foot ulcer (DFU) patients and analyze their relationship with infection.
This is a retrospective cohort study. One hundred and fifty-two patients with DFU in our hospital from July 2020 to March 2022 were selected as the DFU group, including 98 cases in infection stage group and 54 cases in infection control group. The patients were further graded as the mild (51 cases), the moderate (65 cases), and the severe infection group (36 cases) according to the Wagner grading criteria. Sixty-seven patients with foot burns during the same period were selected as the control group. The distribution of pathogenic bacteria on the ulcer surface was examined using fully automated bacterial analyzer. The expression of inflammatory factors (procalcitonin [PCT], tumor necrosis factor-α [TNF-α], and interleukin-6 [IL-6]) was valued by real-time fluorescence quantitative PCR (qRT-PCR). Protein expression was measured by immunohistochemistry (IHC). The correlation was analyzed by Pearson.
The surface infection of DFU patients was mostly induced by gram-negative and gram-positive bacteria, with Pseudomonas aeruginosa predominating among the Gram-negative bacteria and Staphylococcus aureus among the gram-positive bacteria. The infection stage group had higher content of PCT, TNF-α, and IL-6 and lower content of Beclin-1 and LC3 than the infection control group (p < .001). The levels of PCT, TNF-α, and IL-6 in the DFU patients with cardiovascular events were higher than those in the nonoccurrence group (p < .001). Glycated hemoglobin in patients with DFU was positively correlated with PCT, TNF-α, and IL-6 levels (p < .05), and negatively correlated with Beclin-1 and LC3 levels (p < .001).
P. aeruginosa and S. aureus were predominant bacterial in DFU infections. Inflammatory factor and autophagy protein expression were closely correlated with the degree of infection.
观察糖尿病足溃疡（DFU）患者肉芽组织中炎症因子和自噬相关蛋白的表达，并分析其与感染的关系。
这是一项回顾性队列研究。选取我院 2020 年 7 月至 2022 年 3 月收治的 152 例 DFU 患者为 DFU 组，其中感染期 98 例，感染控制期 54 例。根据 Wagner 分级标准，患者进一步分为轻度（51 例）、中度（65 例）和重度感染组（36 例）。同期选取 67 例足部烧伤患者为对照组。采用全自动细菌分析仪检测溃疡表面病原菌分布。采用实时荧光定量 PCR（qRT-PCR）检测炎症因子（降钙素原[PCT]、肿瘤坏死因子-α[TNF-α]和白细胞介素-6[IL-6]）的表达。采用免疫组织化学（IHC）法测定蛋白表达。采用 Pearson 进行相关性分析。
DFU 患者表面感染多由革兰阴性菌和革兰阳性菌引起，其中革兰阴性菌以铜绿假单胞菌为主，革兰阳性菌以金黄色葡萄球菌为主。感染期组 PCT、TNF-α和 IL-6 含量高于感染控制期组，Beclin-1 和 LC3 含量低于感染控制期组（p<0.001）。有心血管事件的 DFU 患者 PCT、TNF-α和 IL-6 水平高于无事件组（p<0.001）。DFU 患者糖化血红蛋白与 PCT、TNF-α和 IL-6 水平呈正相关（p<0.05），与 Beclin-1 和 LC3 水平呈负相关（p<0.001）。
DFU 感染以铜绿假单胞菌和金黄色葡萄球菌为主。炎症因子和自噬蛋白表达与感染程度密切相关。
