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[糖尿病足患者血清白细胞介素-6水平与感染严重程度的相关性]

[Correlation between the level of serum IL-6 and the severity of infection in patients with diabetic foot].

作者信息

Li J Y, Xiong L, Wang P Y, Ma Q F

机构信息

Department of Clinical Laboratory, Liyuan Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430077, China.

出版信息

Zhonghua Yu Fang Yi Xue Za Zhi. 2025 Mar 6;59(3):352-358. doi: 10.3760/cma.j.cn112150-20241111-00885.

DOI:10.3760/cma.j.cn112150-20241111-00885
PMID:40107786
Abstract

To explore the correlation between the level of serum interleukin-6 (IL-6) and the severity of infection in patients with diabetic foot (DF) and the auxiliary value of IL-6 in DF diagnosis, and aim to provide reference for clinical treatment. Based on the hospital medical record system and the laboratory system, a retrospective analysis with case-control study was conducted on the data of patients in Liyuan Hospital affiliated to Tongji Medical College, Huazhong University of Science and Technology from January 2020 to September 2024. A total of 377 patients' information was collected, including 31 cases in control group with 17 males and 14 females from 31 to 91 years old and a median age of 71, 63 cases in NDF group with 43 males and 20 females from 37 to 96 years old, with a median age of 71, and 283 patients in DF group with 197 males and 86 females from 36 to 96 years, with a median age of 67. According to classification of infection severity, paints in the group of diabetes with DF were divided into mild infection subgroup (72 cases), moderate infection subgroup (143 cases) and severe infection subgroup (68 cases). The results showed that there were no statistically significant differences in age and gender among the three groups in the study (=1.795/=2.81, >0.05). The non parametric test results showed that there were statistically significant differences in IL-6, C-reactive protein (CRP), procalcitonin (PCT), white blood cell (WBC) and glucose (GLU) among the three groups of patients (=12.480, 36.277, 12.432, 12.838, 18.334, <0.05). The pairwise comparison results showed that compared with the control group, the NDF group had higher levels of CRP, PCT and GLU (=20.259, 20.118, 20.056, <0.05), and the levels of IL-6, CRP, PCT and WBC(=14.934,14.933,14.829,14.934, <0.05) were higher in the DF group. Both of the differences were statistically significant. But the difference of IL-6, CRP, PCT, WBC and GLU between the NDF and DF group was not statistically significant(=1.202,0.622,0.737,1.036,1.899,). In DF group, there were statistically significant differences in IL-6, CRP, PCT, WBC, and GLU levels among patients in the three infection subgroups (=11.174, 15.136, 8.657, 8.348, 3.698, <0.05).Compared to the mild subgroup, the levels of IL-6, CRP, PCT, WBC and GLU were higher in the severe subgroup were higher(=111.789,237.066,74.683,83.203,15.328, <0.05) and the levels of IL-6, CRP, PCT in the moderate subgroup were higher (=6.877, 8.846, 5.183, <0.05). And both of the differences were statistically significant. But there was no statistically significant difference in WBC and GLU level between the mild and the moderate subgroup(=1.684, 1.039,). The severity of infection in diabetic foot patients was positively correlated with the IL-6 level (=1.033, 95%: 0.024-0.043, <0.05). ROC curve showed that AUC of IL-6 for diagnosis in diabetic foots were 0.635. And joint testing showed that the AUC of IL-6+CRP, IL-6+PCT and IL-6+WBC were 0.718, 0.621, and 0.638 respectively. In conclusion,the level of serum IL-6 may be positively correlated with the severity of infection in diabetic foot patients, which may have auxiliary diagnostic value in predicting diabetic foot infection. And it may provide a reference for the grading of infection severity in diabetic foot patients to gauging serum IL-6 level.

摘要

探讨糖尿病足(DF)患者血清白细胞介素-6(IL-6)水平与感染严重程度的相关性以及IL-6在DF诊断中的辅助价值,旨在为临床治疗提供参考。基于医院病历系统和实验室系统,对华中科技大学同济医学院附属梨园医院2020年1月至2024年9月患者的数据进行回顾性病例对照研究。共收集377例患者信息,其中对照组31例,男性17例,女性14例,年龄31~91岁,中位年龄71岁;非糖尿病足(NDF)组63例,男性43例,女性20例,年龄37~96岁,中位年龄71岁;DF组283例,男性197例,女性86例,年龄36~96岁,中位年龄67岁。根据感染严重程度分类,DF糖尿病组患者分为轻度感染亚组(72例)、中度感染亚组(143例)和重度感染亚组(68例)。结果显示,研究中三组患者的年龄和性别差异无统计学意义(=1.795/=2.81,>0.05)。非参数检验结果显示,三组患者的IL-6、C反应蛋白(CRP)、降钙素原(PCT)、白细胞(WBC)和血糖(GLU)差异有统计学意义(=12.480,36.277,12.432,12.838,18.334,<0.05)。两两比较结果显示,与对照组相比,NDF组CRP、PCT和GLU水平较高(=20.259,20.118,20.056,<0.05),DF组IL-6、CRP、PCT和WBC水平较高(=14.934,14.933,14.829,14.934,<0.05)。两者差异均有统计学意义。但NDF组与DF组之间IL-6、CRP、PCT、WBC和GLU的差异无统计学意义(=1.202,0.622,0.737,1.036,1.899,)。在DF组中,三个感染亚组患者的IL-6、CRP、PCT、WBC和GLU水平差异有统计学意义(=11.174,15.136,8.657,8.

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