Prognostic value of peripheral blood Th1/Th2 cells and their cytokines in elderly patients with diabetic foot ulcers
Objective To explore the prognostic value of peripheral blood Th1/Th2 cells and their cyto-kines in elderly patients with diabetic foot ulcer(DFU).Methods A total of 136 elderly DFU patients admit-ted to our hospital from January 2021 to August 2023 were selected as the study objects,and were divided into mild group(grade 0-2,75 cases)and severe group(grade 3-4,61 cases)according to Wagner grading crite-ria.All patients were given symptomatic treatment,and were followed up for 6 months by regular outpatient reexaminations,WeChat and telephone.According to the 6-month prognosis,they were divided into good prog-nosis group(95 cases)and poor prognosis group(41 cases).Baseline data,peripheral blood Th1 cells and their cytokines[interleukin(IL)-2,interferon γ(INF-γ)],Th2 cells and their cytokines(IL-4,IL-10)were com-pared between the two groups.The predictive efficacy of Th1/Th2 cells and their cytokines on poor prognosis of DFU was evaluated.Results Compared with the good prognosis group,the levels of Th1 cells,IL-2 and INF-γ in peripheral blood of the poor prognosis group were higher,and the levels of Th2 cells,IL-4 and IL-10 were lower,with statistical significance(P＜0.05).Compared with mild group,the levels of Th1 cells,IL-2 and INF-γ in peripheral blood of severe group were higher,and the levels of Th2 cells,IL-4 and IL-10 were lower,with statistical significance(P＜0.05).After adjusting for body mass index(BMI),duration of DFU,vascular complications of diabetes mellitus and severity of DFU,Th1 cells,IL-2,INF-γ,Th2 cells,IL-4 and IL-10 were the independent prognoses of DFU(P＜0.05).The AUC of the combination of Th1 cells,IL-2,INF-γ,Th2 cells,IL-4 and IL-10 predicted the poor prognosis of DFU was greater than that predicted by each indi-cator alone.Conclusion Peripheral blood Th1/Th2 cells and their cytokines are closely related to the degree of disease in elderly DFU patients,and are independent predictors of poor prognosis.The combination of the indicators has a good predictive value for the prognosis of elderly DFU patients.
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