摘要
目的探讨中国老年糖尿病足截肢患者的临床特点及预后。方法对全国39家三甲医院2010年住院的老年糖尿病足截肢患者(≥60岁)及中青年糖尿病足截肢患者(<60岁)进行回顾性调查研究,包括人口学特征、既往病史、糖尿病病程、糖化血红蛋白水平、血脂水平、糖尿病并发症、糖尿病足病的Wagner分级、截肢平面及转归等。结果 440例糖尿病足截肢患者中,老年截肢患者313例,占71.14%,中青年截肢患者127例,占28.86%。与中青年组相比,老年组具有糖尿病病程长,收缩压较高,高血压病、冠心病及脑血管病患病率高,下肢血管病变发病率增高的特点(P<0.05);老年组糖化血红蛋白、空腹血糖、餐后2h血糖水平均显著低于中青年组(P<0.05);老年组截肢一期愈合率较中青年组更低,而住院期间二次或多次截肢发生率则显著增高(P<0.05)。结论中国糖尿病足截肢患者具有高龄化特点,老年糖尿病足截肢患者具有糖尿病病程较长、合并症多、截肢一期愈合率低、二次或多次截肢发生率高的特点。
Objective To explore the clinical characteristics and prognosis of the elderly patients with diabetic foot amputation in China. Methods The clinical data of elderly patients （≥60 years） and young and middle-aged patients （〈60 years） who underwent diabetic foot amputation in 39 central municipal hospitals or the university hospitals all across China for the whole year of 2010 were retrospectively analyzed,including demographic characteristics, past medical history, duration of diabetes, glycosylated hemoglobin level, blood lipid level, diabetes complications,diabetic foot disease based on Wagner grading, the level and prognosis of amputation. Results There were totally 440 diabetic amputations in this study, including 313 in elderly patients （71.14%） and 127 in young and middle-aged patients （28.86%）. Compared with young and middle-aged patients,the elderly patients had a longer duration of diabetes,higher systolic blood pressure, and significantly more elderly patients suffered from hypertension,coronary heart disease, cerebrovascular disease and lower extremity vascular disease （P〈0.05）. The young and middle-aged patients had higher level of glycosylated hemoglobin, fasting plasma glucose, 2 hour postprandial blood glucose than the elderly patients. The primary healing rate in the elderly patients were much lower （P〈0.05） ,and the rate of second or multiple amputation was significantly higher （P〈0.05）. Conclusion Diabetic foot amputation is more prone to occur in elderly patients. The elderly patients with diabetic foot amputation usually have a longer diabetic duration,more comorbidities,lower rate of primary healing and higher rate of second or multiple amputation.
出处
《华中科技大学学报（医学版）》
CAS
CSCD
北大核心
2013年第5期555-559,共5页
Acta Medicinae Universitatis Scientiae et Technologiae Huazhong
关键词
糖尿病
老年
足
截肢术
diabetic
elderly
foot
amputation
