摘要
目的了解2型糖尿病患者糖尿病足(DF)发生的高危因素,并进一步分析可能导致DF截肢的相关因素。方法选取我院确诊的2型糖尿病患者208例,其中DF 89例(DF组),非糖尿病足119例(NDF组)。并根据是否截肢将DF患者分为截肢/趾组(19例)和非截肢/趾组(70例)。回顾性分析患者的临床资料、实验室指标变化及并发症的发生情况,并采用Logistic回归分析DF的危险因素及DF截肢/趾患者的高危因素。结果 DF组患者的年龄、病程、高血压病史、收缩压(SBP)、白细胞计数(WBC)、血小板(PLT)、空腹血糖(FBG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDLC)、糖化血红蛋白(Hb A1c)、超敏C反应蛋白(hs-CRP)、降钙素原(PCT)、周围神经病变(DPN)和外周动脉粥样硬化闭塞症(ASO)与NDF组比较均增高,差异有统计学意义(P<0.05或0.01);血红蛋白(Hb)及踝肱指数(ABI)值与NDF组比较则显著降低(P<0.01)。截趾/肢患者的ABI和Hb低于非截肢/趾患者(P<0.01);而高血压病史、Hb A1c、hs-CRP、PCT、WBC和PLT计数均高于非截肢/趾患者(P<0.05或0.01)。多因素Logistic回归分析显示WBC、Hb A1c、hs-CRP和ASO DF是发生的危险因素;而高WBC和Hb A1c是DF患者发展为截肢/趾的危险因素。结论严格控制高血压、血糖和感染,注意干预异常的ABI和糖尿病并发症可有效预防糖尿病患者发展为DF,并进一步减少DF截肢的发生。
Objective To explore the risk factors of diabetic foot in patients with type 2 diabetes mellitus（T2DM）.To analyze the correlated risk factor of diabetic foot amputation. Methods Two hundred and eight patients with type 2 diabetes were divided into the diabetic foot group（DF, 89 cases） and the non-diabetic foot group（NDF, 119 cases）. And the amputation group and non amputation group were 19 cases and 70 cases respectively. Clinical data, laboratory indexes and complication were analyzed retrospectively in different groups. The risk factors of DF and DF amputation were analyzed by Logistic regression method.Results Compare with NDF group,DF group in age,the course of disease, SBP, hypertension, WBC, PLT, FBG, HDL-C, LDL-C, Hb A1 c, hs-CRP, PCT, DPN and ASO were increased（ P〈0.05）. There was significant difference between 2 groups in hypertension,WBC,PLT,Hb A1 c,hs-CRP and PCT（P〈0.05）. Hb and ABI were decreaed than that of NDF and non-amputation group（P〈0.05）. Logistic regression analysis showed that WBC、Hb A1c、hs-CRP and ASO were independent risk factors of DF patients. And WBC、Hb A1 c were risk factour of diabetic foot amputation. Conclusion DF can be prevented by controlling blood glucose strictly,regulating blood pressure,anti infection and improve blood circulation, and prevent the occurrence of amputation.
出处
《广东医学院学报》
2015年第3期276-279,共4页
Journal of Guangdong Medical College
基金
湛江市科技攻关计划项目(No.2014B01102)
关键词
糖尿病足
截肢
危险因素
diabetic foot amputation risk factors
