糖尿病足溃疡治疗1年内不同阶段病情变化的随访分析  

Disease course of patients with diabetic foot ulcer during one-year follow-up

作　　者：钱泓洁[1,2,3,4] 许蕾[1,2,3] 张杉杉[1,2,3] 方萍[1,2,3] 顾雪明[4] 周云飞[4] 刘宏[4] 顾俊义[4] 汤正义[1,2,3,4] 宁光[1,2,3,4] 

机构地区：[1]上海交通大学医学院附属瑞金医院内分泌代谢病科 [2]上海市内分泌代谢病研究所 [3]上海市内分泌代谢病临床医学中心糖尿病足分中心,上海200025 [4]上海交通大学医学院附属瑞金医院远洋分院内科,上海200031

出　　处：《内科理论与实践》2013年第2期124-127,共4页Journal of Internal Medicine Concepts & Practice

基　　金：国家高技术研究发展计划(项目编号:2011AA020107)

摘　　要：目的:随访糖尿病足溃疡(DFU)患者治疗1年中的病情变化,观察DFU治疗的疗效、心脑血管事件发生情况和影响因素。方法:详细记录158例DFU患者住院期间的一般病史资料及实验室检查指标,随访观察患者3、6及12个月溃疡愈合、复发,心脑血管事件发生及死亡等预后情况。结果:DFU愈合率在随访3、6和12个月分别为75.3%、84.8%和89.2%;随访至12个月时,溃疡复发33例(23.4%),发生心脑血管事件34例(21.5%),死亡12例(7.6%),其中死于心脑血管事件8例(66.7%)。年龄、严重的足溃疡为DFU患者心脑血管事件发生的危险因素(P<0.05)。结论:绝大部分DFU能够愈合,DFU患者足溃疡复发率、心脑血管事件发生率和病死率高,提示后续治疗仍需要严密观察。Objective To observe the healing rate,occurrence of cardiovascular and cerebrovascular events（CCE）,death and associated risk factors in patients with diabetic foot ulcer（DFU） through 1-year follow-up.Methods Pathophysiological and biochemical data from a total of 158 hospitalized patients with DFU were recorded and analyzed.Patients were followed up to observe wound healing and recurrence,incidence of CCE,as well as all-causes of death within 3 months,6 months and 1 year follow-up.Results Ulcer healing rates within 3 months,6 months,and 1 year were 75.3%,84.8% and 89.2%,respectively.Over 1-year follow-up,definite events occurred in 79 patients,including 33 foot ulcer recurrence（23.4%）,34 CCE（21.5%） and 12 deaths（7.5%）;8 patients（66.7% of the death） died from CCE.Age and severe foot ulcer were considered to be the risk factors of CCE（P0.05）.Conclusions The majority of DFU could be rehabilitated,while a high incidence of foot ulcer recurrence,CCE and mortality was still existed,suggesting the need of follow-up observation and treatment.

关 键 词：糖尿病足溃疡 心脑血管事件 病死率 危险因素 

分 类 号：R587.2[医药卫生—内分泌] R632.1[医药卫生—内科学]