ESM-1和sCD163对2型糖尿病足溃疡严重程度及分型的诊断价值OA
Diagnostic value of ESM-1 and sCD163 in severity and typing of diabetic foot ulcers in type 2 diabetes mellitus
目的:探究内皮细胞特异性分子-1(endothelial cell specific molecule-1,ESM-1)和可溶性血红蛋白清道夫受体(soluble hemoglobin scavenger receptor CD163,sCD163)与 2 型糖尿病(T2DM)患者足溃疡的关联性,并评估二者在糖尿病足溃疡中的诊断效能.方法:回顾性分析 2022 年 1 月至 2024 年 12 月上海中医药大学附属普陀医院收治的 226 例 T2DM 患者的临床资料,按是否合并足溃疡分为足溃疡组(n=60)与对照组(n=166),比较两组实验室相关指标和临床病理特征.采用 Logistic 回归分析 T2DM 足溃疡的相关影响因素,采用受试者工作特征(ROC)曲线评估 ESM-1和 sCD163 单独及联合检测的诊断价值.比较不同溃疡类型、不同 Wagner 分级的 T2DM 患者ESM-1、sCD163 水平的差异.结果:T2DM 患者足溃疡患病率为 26.55%.足溃疡组 ESM-1、sCD163 水平均高于对照组(P 均<0.05),且二者呈正相关(r=0.682,P<0.01).合并周围神经病变、糖化血红蛋白、C 反应蛋白、ESM-1与sCD163是 T2DM 足溃疡的影响因素(P 均<0.05).ESM-1 和 sCD163 单独诊断 T2DM 足溃疡的曲线下面积(AUC)分别为 0.846 和 0.845(P 均<0.01),二者联合检测的 AUC 为 0.927,灵敏度为 0.833,特异度为 0.904(P<0.01).ESM-1、sCD163 水平随 Wagner 分级升高而上升,神经 缺血性溃疡显著高于缺血性溃疡与神经性溃疡(P 均<0.05).结论:ESM-1和sCD163 与T2DM 足溃疡密切相关,二者联合检测可显著提升足溃疡的诊断能力,且指标水平与溃疡类型及严重程度相关.
Objective:To explore the correlation of endothelial cell specific molecule-1(ESM-1)and soluble hemoglobin scavenger receptor CD163(sCD163)with foot ulcer in patients with type 2 diabetes mellitus(T2DM),and to evaluate the efficacy of the two indicators in identifying diabetic foot ulcer.Methods:A retrospective analysis was performed on the clinical data of 226 patients with T2DM admitted to our hospital from January 2022 to December 2024.The patients were divided into foot ulcer group(n=60)and control group(n=166)according to whether complicated with foot ulcer.Laboratory examination indicators and clinicopathological characteristics were compared between the two groups.Logistic regression analysis was used to screen the influencing factors of foot ulcer in T2DM patients.Receiver operating characteristic curve was adopted to evaluate the diagnostic value of single and combined detection of ESM-1 and sCD163.The differences in ESM-1 and sCD163 levels were compared among T2DM patients with different ulcer types and Wagner grades.Results:The prevalence of foot ulcer in T2DM patients was 26.55%.The levels of ESM-1 and sCD163 in the foot ulcer group were significantly higher than those in the control group(both P<0.05),and the two indicators were positively correlated(r=0.682,P<0.01).Complicated peripheral neuropathy,glycated hemoglobin,C-reactive protein,ESM-1 and sCD163 were independent influencing factors for foot ulcer in T2DM patients(all P<0.05).The area under the curve(AUC)of ESM-1 and sCD163 alone in diagnosing T2DM foot ulcer was 0.846 and 0.845,respectively(both P<0.01);the AUC of combined detection was 0.927,with a sensitivity of 0.833 and a specificity of 0.904(P<0.01).The levels of ESM-1 and sCD163 increased with the elevation of Wagner grade,and were higher in neuroischemic ulcers than in ischemic ulcers and neuropathic ulcers(both P<0.05).Conclusion:ESM-1 and sCD163 are closely associated with the occurrence of foot ulcer in T2DM patients.Combined detection of the two indicators can be used to significantly improve the identification efficiency of diabetic foot ulcer,and their expression levels are correlated with ulcer type and severity.
周宇;黄荣;李梦帆;曾光;胡俊晟;刘希璇;黄毅
上海中医药大学附属普陀医院普外科,上海 200062上海中医药大学附属普陀医院普外科,上海 200062上海中医药大学附属普陀医院普外科,上海 200062上海中医药大学附属普陀医院普外科,上海 200062上海中医药大学附属普陀医院普外科,上海 200062上海中医药大学附属普陀医院普外科,上海 200062上海中医药大学附属普陀医院普外科,上海 200062
医药卫生
2型糖尿病足溃疡内皮细胞特异性分子-1可溶性血红蛋白清道夫受体
type 2 diabetes mellitusfoot ulcerendothelial cell specific molecule-1soluble hemoglobin scavenger receptor CD163
《江苏大学学报（医学版）》 2026 (3)
230-235,258,7
上海市普陀区卫生健康系统新一轮临床医学学科建设计划(2024tszb03)上海市普陀区卫生健康系统科技创新项目(ptkwws202312)
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