文章摘要
蔡开秀,张艳琳,唐小庆,阮小娇,慕长利.2型糖尿病足溃疡合并营养不良患者血清Tol样受体9、糖化血红蛋白、25羟维生素D检测的临床意义[J].,2020,(24):4656-4659
2型糖尿病足溃疡合并营养不良患者血清Tol样受体9、糖化血红蛋白、25羟维生素D检测的临床意义
Clinical Significance of Serum Tol Receptor 9, Glycosylated Hemoglobin and 25 Hydroxyvitamin D in Patients with Type 2 Diabetic Foot Ulcer Complicated with Malnutrition
投稿时间:2020-06-08  修订日期:2020-06-30
DOI:10.13241/j.cnki.pmb.2020.24.012
中文关键词: 2型糖尿病足溃疡  营养不良  Tol样受体9  糖化血红蛋白  25羟维生素D
英文关键词: Type 2 diabetic foot ulcer  Malnutrition  Tol receptor 9  Glycosylated hemoglobin  25 hydroxyvitamin D
基金项目:重庆市基础与前沿研究计划项目(cstc2015jcyjA10026)
作者单位E-mail
蔡开秀 陆军军医大学第一附属医院内分泌科 重庆 400038 majd8755@163.com 
张艳琳 陆军军医大学第一附属医院内分泌科 重庆 400038  
唐小庆 陆军军医大学第一附属医院内分泌科 重庆 400038  
阮小娇 陆军军医大学第一附属医院内分泌科 重庆 400038  
慕长利 陆军军医大学第一附属医院内分泌科 重庆 400038  
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中文摘要:
      摘要 目的:检测2型糖尿病足溃疡合并营养不良患者血清Tol样受体9(TLR9)、糖化血红蛋白(HbA1c)、25羟维生素D[25-(OH)D3]的水平,并分析其临床意义。方法:选择2018年3月~2019年3月我院收治的2型糖尿病足溃疡患者81例,根据预后营养指数(PNI)对患者营养状况进行评估并分组,PNI≤50患者作为营养不良组27例,PNI>50患者作为营养正常组54例,检测并比较两组营养指标、体重指数(BMI)、PNI值、血糖、血脂、TLR9、HbA1c、25-(OH)D3。结果:营养不良组患者PNI值、BMI、血清总蛋白(TP)、血清白蛋白(ALB)、血清前白蛋白(PA)显著低于营养正常组(P<0.05),而营养不良组患者空腹血糖(FBG)、餐后2 h血糖(PBG)显著高于营养正常组(P<0.05)。两组患者总胆固醇(TC)、三酰甘油(TG)水平无显著差异(P>0.05),营养不良组患者血清TLR9、HbA1c水平显著高于营养正常组(P<0.05),而25-(OH)D3水平显著低于营养正常组(P<0.05)。血清TLR9、HbA1c与PNI值、BMI、TP、ALB、PA均呈显著负相关关系(P<0.05),而与FBG、PBG呈显著正相关关系(P<0.05);血清25-(OH)D3与PNI值、BMI、TP、ALB、PA均呈显著正相关关系(P<0.05),而与FBG、PBG呈显著负相关关系(P<0.05)。结论:2型糖尿病足溃疡合并营养不良患者血清TLR9、HbA1c及25-(OH)D3水平与机体营养状况及血糖控制密切相关,有望成为患者疾病监测及营养风险评估的潜在指标。
英文摘要:
      ABSTRACT Objective: To detecte the tol receptor 9 (TLR9), glycosylated hemoglobin (HbA1c) and 25 hydroxyvitamin D[25-(OH)D3] levels in patients with type 2 diabetic foot ulcer complicated with malnutrition, and to analyze their clinical significance. Methods: 81 patients with type 2 diabetic foot ulcer who were admitted to our hospital from March 2018 to March 2019 were selected. The nutritional status of the patients was evaluated and grouped according to the prognostic nutritional index (PNI). 27 patients with PNI≤50 were treated as malnutrition group, and 54 patients with PNI>50 were treated as normal nutrition group. Nutritional indicators, body mass index (BMI), PNI, blood glucose, blood lipids, TLR9, HbA1c, 25-(OH)D3 were measured and compared between the two groups. Results: PNI value, BMI, serum total protein (TP), serum albumin (ALB) and serum prealbumin (PA) in the malnutrition group were significantly lower than those in the normal nutrition group (P<0.05). Fasting blood glucose (FBG) and 2 h postprandial blood glucose (PBG) in the malnutrition group were significantly higher than those in the normal nutrition group (P<0.05). There were no significant differences in total cholesterol (TC) and triacylglycerol (TG) levels between the two groups (P>0.05). Serum TLR9 and HbA1c levels in the malnutrition group were significantly higher than those in the normal nutrition group (P<0.05), while the 25-(OH)D3 level was significantly lower than that in the normal nutrition group (P<0.05). Serum TLR9 and HbA1c were significantly negatively correlated with PNI, BMI, TP, ALB and PA (P<0.05), while serum FBG and PBG were significantly positively correlated (P<0.05). Serum 25-(OH)D3 was significantly positively correlated with PNI, BMI, TP, ALB and PA(P<0.05), while significantly negatively correlated with FBG and PBG (P<0.05). Conclusion: Serum TLR9, HbA1c and 25-(OH)D3 levels in patients with type 2 diabetic foot ulcer complicated with malnutrition are closely related to nutritional status and blood glucose control, and which are expected to be potential indicators for disease monitoring and nutritional risk assessment in patients.
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