CD64对糖尿病足病感染程度及预后的价值探讨

目的 比较CD64、C反应蛋白、降钙素原及白细胞计数在评估糖尿病足病感染程度及预后中的价值，寻找临床中反映感染的可靠指标。方法 研究对象选取2014年8月~2015年12月于笔者医院住院的2型糖尿病合并糖尿病足病的106例患者，采集患者的临床资料，如性别、年龄、病程、血糖、血压、血脂、糖化血红蛋白、肾功能、ABI、糖尿病并发症及合并症情况，根据感染程度分无感染组（22例）、轻度感染组（30例）、中度感染组（41例）和重度感染组（13例），比较各组间的CD64、CRP、PCT及WBC；根据糖尿病足病的预后情况分有效组（89例）和未愈组（17例），分析CD64在糖尿病足病预后的作用。结果 随着感染程度的加重，CD64、CRP、PCT及WBC均逐渐升高（P均<0.05），轻度感染组、中度感染组、重度感染组的CD64、C反应蛋白、降钙素原及白细胞计数均显著高于无感染组（P均<0.05）；不同感染程度组的CD64与CRP、PCT、WBC呈正相关（P均<0.01）。单因素分析显示，糖尿病足病程、糖化血红蛋白、肌酐、ABI、CD64是糖尿病足病预后的危险因素（P均<0.05）；多因素Logistic回归分析，糖尿病足病程、ABI、CD64是足病预后的独立危险因素（P均<0.05）。结论 CD64是评估糖尿病足病感染程度和预后的良好炎性指标。

Value of CD64 in the Infection Degree and Prognosis of Diabetic Foot Disease

Objective To compare the value of CD64,C reactive protein, procalcitonin and white blood cell count in the infection degree and prognosis of diabetic foot and find a reliable index to reflect the infection. Methods From August 2014 to December 2015 in our hospital, 106 cases of type 2 diabetes mellitus with diabetic foot patients were recruited.The clinical data of patients were collected, including gender, age, duration, Serum glucose,blood pressure, blood lipid, glycated hemoglobin,renal function, Ankle Brachial Index and complications of diabetes.According to the degree of infection,the patients were divided into four groups,including non-infection group (22 cases), mild infection group (30 cases), moderate infection group (41 cases) and severe group (13 cases).CD64,PCT,CRP and WBC were compared. According to the prognosis of diabetic foot, the patients were divided into effective group (89 cases) and unhealed group (17 cases),CD64 was analyzed in the prognosis of diabetic foot. Results With increasing the degree of infection, CD64,PCT,CRP and WBC were gradually increased (P all<0.05). CD64,PCT,CRP and WBC in the mild group, moderate group and severe infection group were significantly higher than those of non-infection, (P all<0.05). Different group of CD64,PCT,CRP and WBC were positively correlated (P all<0.01).In single factor analysis, duration of diabetic foot, glycosylated hemoglobin, creatinine, ABI, CD64 is a risk factor for the prognosis of diabetic foot (P all<0.05).In Multiariable Logistic regression analysis, duration of diabetic foot, ABI, CD64 is independent risk factors of prognosis. Conclusion CD64 is a good indicator of inflammation in response to infection and prognosis of patients with diabetic foot.