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Received:August 26, 2024 Published Online:April 20, 2025
Received:August 26, 2024 Published Online:April 20, 2025
中文摘要: 目的 探讨在糖尿病足溃疡患者中，血浆致动脉粥样硬化指数（AIP）与其小截肢（踝关节以下）发生的关系。方法 采用回顾性横断面研究方法，选取2020年1月至2022 年6月在太原市中心医院内分泌科住院的2型糖尿病足溃疡患者207例。根据患者是否行小截肢术分为非截肢组（n =107）和小截肢组（n =100）。收集并比较两组患者基线资料及AIP。采用单因素和多因素logistic回归分析AIP与糖尿病足小截肢之间的关系，采用受试者工作特征（ROC）曲线分析AIP及其联合指标对糖尿病足小截肢的诊断价值。结果 小截肢组患者AIP的水平显著低于非截肢组［0.11 (-0.04, 0.26) vs 0.16 (0.08, 0.32)， Z=2.940， P=0.003］。多因素logistic回归分析显示，纤维蛋白原高、周围血管病、饮酒史、坏疽、住院时间长及住院次数多是糖尿病足患者小截肢的危险因素（P＜0.05），而高水平的身体质量指数（BMI）、空腹血糖、总胆固醇和AIP为保护因素（P＜0.05）。ROC曲线分析显示，单独AIP预测小截肢的ROC曲线下面积（AUC）为0.618，敏感度为74.8%，特异度为44.0%，最佳截断值为0.08；AIP联合总胆固醇、空腹血糖、饮酒史、坏疽、住院次数及住院时长预测小截肢的AUC为0.900，敏感度为86.0%，特异度为79.0%。结论 AIP水平的下降与糖尿病足溃疡患者发生小截肢的风险增加相关。
Abstract:Objective To explore the relationship between atherogenic index of plasma (AIP) and the occurrence of minor amputations (below ankle joint) in patients with diabetic foot ulcers. Methods A retrospective cross-sectional research was used to select 207 patients with type 2 diabetic foot ulcers who were hospitalized in the Endocrinology Department of Taiyuan Central Hospital between January 2020 and June 2022. Based on whether the patients underwent a minor amputation, the patients were divided into a non-amputation group (n =107) and a minor amputation group (n =100). Baseline data and AIP levels were collected and compared between the two groups. The relationship between AIP and minor amputation in diabetic foot was studied using univariate and multivariate logistic regression analysis. The diagnostic value of AIP and its combined indicators for minor amputation in diabetic foot was analyzed using the receiver operating characteristic (ROC) curve. Results The level of AIP in the minor amputation group was significantly lower than that in the non-amputation group ［0.11 (-0.04, 0.26) vs 0.16 (0.08, 0.32), Z=2.940, P=0.003］. Multivariate logistic regression analysis showed that high fibrinogen, peripheral vascular disease, drinking history, gangrene, long hospital stay, and multiple hospitalizations were risk factors for minor amputation in patients with diabetic foot (P＜0.05), whereas high levels of body mass index, fasting blood glucose, total cholesterol, and AIP were protective factors (P＜0.05). ROC curve analysis showed that the area under the ROC curve (AUC) for AIP alone predicting minor amputation was 0.618, with a sensitivity of 74.8%, specificity of 44.0%, and the optimal cut-off value of 0.08. The AUC for AIP combined with total cholesterol, fasting blood glucose, drinking history, gangrene, hospitalization times and length of stay was 0.900, with a sensitivity of 86.0%, specificity of 79.0%. Conclusion A decrease in AIP levels is associated with an increased risk of minor amputation in patients with diabetic foot ulcers.
keywords: Atherogenic index of plasma Diabetic foot Minor amputation Peripheral vascular disease Diabetes mellitus Fibrinogen
文章编号： 中图分类号：R587.2 文献标志码：A
基金项目:太原市科学技术局国家区域医疗中心科技创新计划项目（202210）
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