血清Galectin-3水平与糖尿病足介入治疗预后的关系

The relationship between serum galectin-3 expression level and prognosis of diabetic foot after interventional therapy

摘要:

目的 探讨血清Galectin-3（Gal-3）水平与糖尿病足介入治疗预后的关系。方法 选取2016年3月—2018年12月天津市第五中心医院收治的80例糖尿病足患者，在介入治疗6个月后行数字减影血管造影（DSA）评估血管再狭窄情况，并将患者分为再狭窄组与非狭窄组。比较两组患者的一般资料、白细胞计数（WBC）、血清C反应蛋白（CRP）、血清降钙素原（PCT）、血清Gal-3。采用多因素Logistic回归分析介入治疗后再狭窄的影响因素。绘制ROC曲线分析血清Gal-3对糖尿病足介入治疗预后的价值。结果 再狭窄组Gal-3、WBC、CRP、PCT水平较非狭窄组高（P <0.05）。再狭窄组Wagner分期3期、无骨髓炎、无肢体缺血的占比较非狭窄组高（P <0.05）。Wagner分期［R=3.116（95% CI：1.279，7.591）］、肢体缺血［R=8.749（95% CI：1.895，40.393）］、CRP［R=5.521（95% CI：1.303，23.393）］、PCT［R=6.359（95% CI：1.804，22.415）］、Gal-3［R=7.962（95% CI：1.636，38.749）］是糖尿病足介入治疗后血管再狭窄的影响因素。血清Gal-3预测糖尿病足介入治疗后再狭窄的ROC曲线下面积为0.885（95% CI：0.799，0.960），当Gal-3为5.78 ng/ml时，敏感性与特异性最高，分别达0.875（95% CI：0.751，0.943）和0.719（95% CI：0.629，0.893）。结论 血清Gal-3水平是糖尿病足介入治疗预后的影响因素，积极检测血清Gal-3有利于预测患者介入术后血管再狭窄风险。

Abstract:

Objective To investigate the relationship between serum galectin-3 (Gal-3) expression and prognosis of diabetic foot after interventional therapy.Methods The study was carried out on 80 diabetic foot patients admitted to our hospital from March 2016 to December 2018. Digital subtraction angiography (DSA) was performed 6 months after interventional therapy to evaluate the vascular restenosis, based on which the patients were divided into restenosis group and non-restenosis group. The general data, white blood cell (WBC) count, serum C-reactive protein (CRP), serum procalcitonin (PCT), and serum Gal-3 were compared between the two groups of patients. Multivariate Logistic regression was used to analyze the influencing factors of restenosis after interventional therapy. The receiver operating characteristic (ROC) curve was applied to analyze the predictive value of serum Gal-3 for the prognosis of diabetic foot after interventional therapy.Results There was no significant difference in gender, age, course of disease, ulcer area, and ulcer history between the non-restenosis group and the restenosis group (P > 0.05). The restenosis group showed higher serum levels of Gal-3, WBC count, CRP and PCT, and the proportion of Grade-Ⅲ diabetic foot of Wagner classification, but lower incidence of osteomyelitis and limb ischemia compared with non-restenosis group (P < 0.05). The multivariate Logistic regression analysis showed that the grade of diabetic foot of Wagner classification [R = 3.116 (95% CI: 1.279, 7.591)], limb ischemia [R=8.749 (95% CI: 1.895, 40.393)], serum CRP [R = 5.521 (95% CI: 1.303, 23.393)], serum PCT [R=6.359 (95% CI: 1.804, 22.415)], and serum Gal-3 [R=7.962 (95% CI: 1.636, 38.749)] were the influencing factors of vascular restenosis after interventional therapy of diabetic foot (P < 0.05). The area under the ROC curve of serum Gal-3 in predicting vascular restenosis after interventional therapy of diabetic foot was 0.885 (95% CI: 0.799, 0.960). The optimal cut-off value of serum Gal-3 was 5.78 ng/ml, with the sensitivity and specificity being highest and reaching 0.875 (95% CI: 0.751, 0.943) and 0.719 (95% CI: 0.629, 0.893), respectively.Conclusions The serum Gal-3 level is an influencing factor for the prognosis of diabetic foot after interventional therapy. The detection of serum Gal-3 is conducive to predicting the risk of vascular restenosis after interventional therapy of diabetic foot.