目的 探讨Hsa_circ_0003928 在糖尿病足溃疡(DFU)中的表达及其与病情严重程度及预后的关系.方法 选取 2020 年 1 月至 2022 年 12 月于我院内分泌科收治的DFU患者 113 例,按照感染严重程度分为 1 级 19 例(无感染)、2 级 40 例(轻度感染)、3 级 20 例(中度感染)及 4 级 34 例(重度感染).根据DFU患者预后情况分为预后良好组(GP,n=63)和预后不良组(PP,n=50).比较各组基线资料及IL-6、C-RP、Hsa_circ_0003928.Logistic回归分析DFU患者预后不良的影响因素.受试者工作特征(ROC)曲线分析Hsa_circ_0003928、C-RP及IL-6 预测DFU患者预后不良的价值.结果 PP组DFU病程、感染程度 3~4 级、血肌酐、BUN、血尿酸、C-RP、IL-6 及Hsa_circ_0003928 高于GP组(P<0.05 或P<0.01).3~4 级DFU患者Hsa_circ_0003928 表达高于 1~2 级(P<0.01).Logistic回归分析显示,DFU病程长、感染程度 3~4 级以及BUN、C-RP、IL-6、Hsa_circ_0003928 升高是DFU患者预后不良的影响因素.ROC曲线分析显示,Hsa_circ_0003928 预测DFU患者预后不良的曲线下面积最大(0.882,95%CI 0.819~0.942),敏感度为 87.5%,特异度为 85.6%.结论 Hsa_circ_0003928 升高与DFU患者病情严重程度及预后不良相关,对DFU患者预后不良有较好的预测价值.
Objective To investigate the expression of serum Hsa_circ_0003928 in patients with diabetic foot ulcer(DFU)and its relationship with the severity and prognosis of disease.Methods 113 DFU patients were selected as the study subjects.According to the severity of infection,19 cases were classified into level 1(no infection),40 cases at level 2(mild infection),20 cases at level 3(moderate infection),and 34 cases at level 4(severe infection).According to the prognosis of DFU patients,they were divided into good prognosis group(GP,n=63)and poor prognosis group(PP,n=50).The baseline data and levels of IL-6,C-RP and Hsa_circ_0003928 were compared among the four groups.Logistic regression was used to analyze the risk factors of poor prognosis in patients with DFU.The receiver operating characteristic(ROC)curve was used to analyze the value ofHsa_circ_0003928,C-RP and IL-6 in predicting the poor prognosis in DFU patients.Results The DFU duration,infection grade 3~4,serum creatinine,uric acid,BUN,C-RP,IL-6 and Hsa_circ_0003928 levels in PP group were significantly higher than those in GP group(P<0.05 or P<0.01).Grade 3~4 DFU patients had higher Hsa_circ_0003928 expression than grade 1~2(P<0.01).Logistic regression analysis showed that long duration of DFU,infection grade 3~4,higher levels of BUN,C-RP,IL-6 and Hsa_circ_0003928 were risk factors for poor prognosis in DFU patients.ROC curve showed that Hsa_circ_0003928 had the greatest AUC(0.882,95%CI 0.819~0.942)in predicting poor prognosis in DFU patients,with sensitivity 87.5%and specificity 85.6%,respectively.Conclusion Elevated Hsa_circ_0003928 is associated with DFU severity and poor prognosis,which has certain predictive value for the prognosis of DFU patients.