【摘要】 目的:研究和分析感染深度与糖尿病足(DF)患者下肢血管病变及血清炎症因子、免疫球蛋白水平的相关性,为感染性疾病的预防和控制提供研究依据。方法:选取2016年10月～2017年11月的106例DF合并感染患者作为研究对象。对患者的感染深度、下肢血管病变程度进行观察和比较。对患者的血清C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、免疫球蛋白(Ig)-A、Ig-M、Ig-G水平进行检测和比较。结果:有49例患者为深部感染占46.23%,57例患者为浅部感染占53.77%,深部感染患者的下肢血管病变分级显著高于浅部感染患者,差异有统计学意义。深部感染患者的血清CRP、TNF-α、IL-6水平分别为(9.46±3.15)mg/L、(25.26±1.63)ng/L、(136.64±7.23)mg/L均显著高于浅部感染患者的(5.13±1.28)mg/L、(18.04±1.75)ng/L、(118.86±7.34)mg/L,差异有统计学意义。深部感染患者的血清IgA、IgG、IgM水平分别为(0.48±0.27)g/L、(6.82±1.96)g/L、(0.61±0.17)g/L均显著低于浅部感染患者的(1.02±0.53)g/L、(10.62±2.33)g/L、(1.19±0.32)g/L,差异有统计学意义。Spearman等级相关分析结果显示,糖尿病足患者的下肢血管病变程度与血清炎症因子水平呈正相关关系,与血清免疫球蛋白水平呈负相关关系。结论:存在深部感染的DF患者的下肢血管病变程度更高,机体炎症反应和体液免疫功能异常更加严重,下肢血管病变可能促进了DF患者感染的扩散和机体内环境的紊乱,临床医生应给予及时的诊断和有效的干预。更多还原

【Abstract】 Objective To study and analyze the correlation the infection depth and the lower extremity vascular disease,the serum inflammatory factors,the immunoglobulin levels in the patients with diabetic foot (DF) to provide the basis for the prevention and control of the infectious diseases.Methods 106 cases of patients with DF complicated with infections from October of 2016 to November of 2017 were selected as the research subjects.The depth of infections and the degree of lower extremity vascular lesions of the patients were observed and compared.The serum levels of C reactive protein (CRP),tumor necrosis factor α (TNF-α),interleukin 6(IL-6),immunoglobulin (Ig)-A,Ig-M and Ig-G were detected and compared.Results There were 49 cases with deep infections accounting for 46.23%,57 cases with shallow infections accounting for 53.77%.The degree of lower extremity vascular lesions of the patients with deep infections were significantly higher than that with shallow infections,the difference was statistically significant.The levels of serum CRP,TNF-α and IL-6 of the patients with deep infections were (9.46±3.15) mg/L,(25.26±1.63) ng/L,(136.64±7.23) mg/L respectively,which were higher than (5.13±1.28) mg/L,(18.04±1.75) ng/L,(118.86±7.34) mg/L of the patients with shallow infections,the differences were statistically significant.The levels of serum IgA,IgG,IgM of the patients with deep infections were (0.48±0.27) g/L,(6.82±1.96) g/L,(0.61±0.17) g/L respectively,which were significantly lower than (1.02±0.53) g/L,(10.62±2.33) g/L,(1.19±0.32) g/L of the patients with shallow infections,the differences were statistically significant.The results of Spearman correlation analysis showed that the degree of lower extremity vascular disease in the patients with diabetic foot was positively correlated with the levels of the serum inflammatory factors,and negatively correlated with the levels of the serum immunoglobulin.Conclusions The degree of lower extremity vascular diseases of DF patients complicated with deep infections is higher,and the inflammatory reactions and the humoral immune function abnormality are more serious in the body.The lower extremity vascular diseases may promote the spread of infections and the disorders of the environment in the bodies of the DF patients,and the clinicians should give timely diagnosis and effective interventions.更多还原