血清白蛋白对糖尿病足溃疡术后愈合的生物标志物预测：一项回顾性观察研究。
Biomarker Prediction of Postoperative Healing of Diabetic Foot Ulcers: A Retrospective Observational Study of Serum Albumin.
机构信息
Pu Cheng, MD, Department of Burn and Plastic Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
Yunxian Dong, MD, Department of Burn and Plastic Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
出版信息
J Wound Ostomy Continence Nurs. 2021;48(4):339-344. doi: 10.1097/WON.0000000000000780.
PURPOSE
The purpose of this study was to investigate the relationship and to determine potential usefulness of serum albumin as a biomarker for predicting postoperative diabetic foot ulcer (DFU) healing.
DESIGN
A retrospective study.
SUBJECTS AND SETTING
The sample comprised 266 inpatients with type 2 diabetes receiving care in The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China. Among them, 174 had DFUs and underwent surgery for foot DFUs including amputation, skin grafting, and flap procedures. A comparison group consisted of 92 inpatients without a DFU or surgery.
METHODS
The association between healing and preoperative albumin levels was analyzed via a logistic regression model and receiver operating characteristic (ROC) curve.
RESULTS
The albumin value of patients with DFU grade 3 or more (3.23 ± 0.58 g/dL) was lower than that of patients with DFU grade 1-2 (3.58 ± 0.5 g/dL), and both were lower than that of the comparison group (3.89 ± 0.3 g/dL). Patients with a DFU with hypoalbuminemia (<3.5 g/dL) had a 2.5-fold higher risk of nonhealing at postoperative 28 days than patients with normal levels (odds ratio = 3.51; 95% confidence interval, 1.75-7.06; P < .001). For patients with a DFU overall, the ROC curve showed a preoperative albumin cutoff of 3.44 g/dL for DFU wound healing.
CONCLUSIONS
For patients with a DFU undergoing surgery, preoperative serum albumin may be used as a biomarker for predicting postoperative healing.
目的
本研究旨在探讨血清白蛋白作为预测术后糖尿病足溃疡（DFU）愈合的生物标志物的相关性和潜在作用。
设计
回顾性研究。
受试者和设置
本样本包括 266 名在中山大学附属第一医院接受治疗的 2 型糖尿病住院患者，其中 174 名患有 DFU，并接受了足部 DFU 手术，包括截肢、植皮和皮瓣手术。对照组包括 92 名无 DFU 或手术的住院患者。
方法
通过逻辑回归模型和受试者工作特征（ROC）曲线分析愈合与术前白蛋白水平之间的关系。
结果
DFU 3 级或更高级别的患者白蛋白值（3.23±0.58 g/dL）低于 DFU 1-2 级的患者（3.58±0.5 g/dL），且均低于对照组（3.89±0.3 g/dL）。DFU 低白蛋白血症（<3.5 g/dL）患者在术后 28 天非愈合的风险是正常水平患者的 2.5 倍（比值比=3.51；95%置信区间，1.75-7.06；P<.001）。对于所有患有 DFU 的患者，ROC 曲线显示术前白蛋白截断值为 3.44 g/dL 可预测 DFU 伤口愈合。
结论
对于接受手术的 DFU 患者，术前血清白蛋白可作为预测术后愈合的生物标志物。
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