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目的探讨血清25-羟基维生素D[25-(OH)D]、D-二聚体(DD)及糖化血红蛋白(HbA1c)含量与糖尿病足病的关联性,为糖尿病足病防控提供参考。方法 70例2型糖尿病患者作为研究对象,按照是否并发糖尿病足分为实验组(30例,并发糖尿病足)与对照组(40例,未并发糖尿病足),另选40例正常健康人作为参照组;测定并比较三组25-(OH)D、DD及HbA1c水平。结果实验组患者DD水平较对照组显著增高,差异具有统计学意义(t=31.70,P<0.05),两组25-(OH)D、HbA1c水平比较差异无统计学意义(t=1.12、1.07,P>0.05);实验组与参照组25-(OH)D、DD、HbA1c水平比较,差异具有统计学意义(t=27.80、68.60、10.71,P<0.05);对照组与参照组25-(OH)D、DD、HbA1c水平比较,差异具有统计学意义(t=30.08、61.13、12.15,P<0.05)。结论 2型糖尿病及其足病患者DD明显高于正常人,同时糖尿病患者出现25-(OH)D明显降低,可通过对患者适量补充维生素D防控疾病。仅用HbA1c不能准确评估糖尿病足的发生,应结合相关指标进行预判。血浆DD水平对糖尿病足病诊断的cut off值及其补充25-(OH)D剂量范围,依然有待同行大范围实验数据的支持。
Objective To investigate the relationship between serum 25-hydroxyvitamin D [25- (OH) D], D-dimer and HbA1c in diabetic foot disease. Methods Seventy patients with type 2 diabetes mellitus (T2DM) were enrolled in this study. The patients with type 2 diabetes mellitus (DM) were divided into experimental group (30 cases with diabetic foot) and control group (40 cases without diabetic foot), and 40 healthy controls Group. The levels of 25- (OH) D, DD and HbA1c in three groups were measured and compared. Results The level of DD in experimental group was significantly higher than that in control group, the difference was statistically significant (t = 31.70, P <0.05). The difference of 25- (OH) D and HbA1c in two groups was not statistically significant , P> 0.05). The difference of 25- (OH) D, DD, HbA1c between the experimental group and the reference group was statistically significant (t = 27.80,68.60,10.71, P < (OH) D, DD, HbA1c levels, the difference was statistically significant (t = 30.08,61.13,12.15, P <0.05). Conclusions DD in type 2 diabetic patients and their podiatric patients is significantly higher than that in normal subjects. In the meantime, the 25- (OH) D in diabetic patients is significantly lower than that in normal controls. HbA1c alone can not accurately assess the occurrence of diabetic foot should be combined with the relevant indicators of pre-judgment. The cut off value of plasma DD level in the diagnosis of diabetic foot disease and the dose range of 25- (OH) D supplement are still to be supported by a large number of experimental data from colleagues.