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糖尿病足溃疡的危险因素及创面组织血管内皮生长因子对预后的预测价值。

The risk factors in diabetic foot ulcers and predictive value of prognosis of wound tissue vascular endothelium growth factor.

机构信息

Department of Oncology, The Second People's Hospital of Lianyungang, No. 41 Hailiandong Road, Haizhou District, Lianyungang, 222006, China.

Department of Orthopedics, The Sixth Affiliated Hospital of Xinjiang Medical University, No. 39 Wuxingnan Road, Tian Shan District, Urumqi, 830002, China.

出版信息

Sci Rep. 2024 Jun 19;14(1):14120. doi: 10.1038/s41598-024-64009-4.

Abstract

Diabetic foot ulcer (DFU) is a leading cause of high-level amputation in DM patients, with a low wound healing rate and a high incidence of infection. Vascular endothelial growth factor (VEGF) plays an important role in diabetes mellitus (DM) related complications. This study aims to explore the VEGF expression and its predictive value for prognosis in DFU, in order to provide basis for the prevention of DFU related adverse events. We analyzed 502 patients, with 328 in healing group and 174 in non-healing/recurrent group. The general clinical data and laboratory indicators of patients were compared through Spearman correlation analysis, ROC analysis and logistic regression analysis. Finally, the independent risk factors for adverse prognosis in DFU patients were confirmed. Spearman analysis reveals a positive correlation between the DFU healing rate and ABI, VEGF in wound tissue, and positive rate of VEGF expression, and a negative correlation with DM duration, FPG, HbA1c, TC, Scr, BUN, and serum VEGF. Further logistic regression analysis finds that the DM duration, FPG, HbA1c, ABI, serum VEGF, VEGF in wound tissue, and positive rate of VEGF expression are the independent risk factors for adverse prognosis in DFU (p < 0.05). DM duration, FPG, HbA1c, ABI, serum VEGF, VEGF in wound tissue, and positive rate of VEGF expression are the independent risk factors for prognosis in DFU patients. Patients with these risk factors should be screened in time, which is of great significance to prevent DFU related adverse events and improve outcomes.

摘要

糖尿病足溃疡(DFU)是糖尿病(DM)患者发生高水平截肢的主要原因,其伤口愈合率低,感染发生率高。血管内皮生长因子(VEGF)在糖尿病相关并发症中起重要作用。本研究旨在探讨 VEGF 表达及其对 DFU 预后的预测价值,为预防 DFU 相关不良事件提供依据。我们分析了 502 例患者,其中 328 例在愈合组,174 例在未愈合/复发组。通过 Spearman 相关分析、ROC 分析和逻辑回归分析比较患者的一般临床资料和实验室指标。最后,确定了 DFU 患者不良预后的独立危险因素。Spearman 分析显示,DFU 愈合率与 ABI、创面组织 VEGF 和 VEGF 表达阳性率呈正相关,与 DM 病程、FPG、HbA1c、TC、Scr、BUN 和血清 VEGF 呈负相关。进一步的逻辑回归分析发现,DM 病程、FPG、HbA1c、ABI、血清 VEGF、创面组织 VEGF 和 VEGF 表达阳性率是 DFU 不良预后的独立危险因素(p<0.05)。DM 病程、FPG、HbA1c、ABI、血清 VEGF、创面组织 VEGF 和 VEGF 表达阳性率是 DFU 患者预后的独立危险因素。这些危险因素的患者应及时进行筛查,这对预防 DFU 相关不良事件和改善结局具有重要意义。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a4d1/11187195/35a570a86c66/41598_2024_64009_Fig1_HTML.jpg

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