广西医学

目的探讨甘油三酯葡萄糖乘积指数（TyG）、纤维蛋白原（FIB）对2型糖尿病患者并发糖尿病足溃疡（DFU）的预测价值。方法回顾性分析358例2型糖尿病患者的临床资料，将138例未并发DFU的患者作为T2DM组，220例并发DFU的患者作为DFU组，进一步根据Wagner分级将DFU组患者分为轻度DFU组（Wagner 1~2级）106例和重度DFU组（Wagner 3~5级）114例。采用多因素Logistic回归模型分析2型糖尿病患者并发DFU的影响因素，绘制受试者工作特征（ROC）曲线评估TyG、FIB对2型糖尿病患者并发DFU的预测价值，采用Spearman相关法分析TyG、FIB与DFU组患者Wagner分级的相关性。结果多因素Logistic回归分析结果显示，TyG、FIB、2型糖尿病病程是2型糖尿病患者并发DFU的独立危险因素（P<0.05）。ROC曲线分析结果显示，TyG、FIB单独和联合预测2型糖尿病患者并发DFU的曲线下面积（AUC）分别为0.601、0.847、0.873，联合检测的AUC更大。Spearman相关分析结果显示，DFU组患者的TyG、FIB与Wagner分级均呈正相关（P<0.05）。结论 TyG、FIB是2型糖尿病患者并发DFU的独立危险因素，二者可用于评估DFU病情严重程度，对2型糖尿病患者并发DFU有一定的预测价值，且联合检测的效能更高。

Objective To investigate the predictive value of triglyceride⁃glucose index (TyG) and fibrinogen (FIB) on patients with type 2 diabetes mellitus and concomitant diabetic foot ulcer (DFU). Methods The clinical data of 358 patients with type 2 diabetes mellitus were retrospectively analyzed, among which there were 138 patients who was not concomitant DFU (the T2DM group), and 220 patients who was concomitant DFU (the DFU group), and then patients of the DFU group were further assigned to mild DFU group (Wagner classification in 1-2, 106 cases) or severe DFU group (Wagner classification in 3-5, 114 cases) according to Wagner classification. The multivariate Logistic regression model was used to analyzed the influencing factors for patients with type 2 diabetes mellitus and concomitant DFU, and the predictive value of TyG and FIB on patients with type 2 diabetes mellitus and concomitant DFU was evaluated by drawing the receiver operating characteristic (ROC) curve. The correlation of TyG and FIB with Wagner classification of patients in the DFU group was analyzed by using the Spearman correlation method. Results The results of multivariate Logistic regression analysis revealed that TyG, FIB, and disease course of type 2 diabetes mellitus were the independent risk factors for patients with type 2 diabetes mellitus and concomitant DFU (P<0.05). The results of ROC curve analysis indicated that areas under the curve (AUC) of TyG and FIB for alone and jointly predicting patients with type 2 diabetes mellitus and concomitant DFU were 0.601, 0.847, and 0.873, respectively, and AUC of combined detection was greater. The results of Spearman correlation analysis interpreted that TyG and FIB positively correlated with Wagner classification in patients of the DFU group (P<0.05). Conclusion TyG and FIB are the independent risk factors for patients with type 2 diabetes mellitus and concomitant DFU, and the two can be used to evaluate disease severity of DFU, exerting predictive value on patients with type 2 diabetes mellitus and concomitant DFU to a certain extent, and the efficiency of combined detection is higher.