糖尿病足溃疡预后相关因素研究  

Prognostic factors for diabetic foot ulcer

作　　者：刘传波[1] 黄瑶[2] 叶俊娜[1] 倪鹏文[2] 陆树良[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院灼伤整形科,上海市烧伤研究所,上海市创面修复中心,200025 [2]上海交通大学医学院附属上海第九人民医院创面修复科,200025

出　　处：《中华创伤杂志》2014年第4期291-297,共7页Chinese Journal of Trauma

基　　金：国家重点基础研究发展计划资助项目（2012CB518105）;国家科技支撑计划资助项目（2012BAI11B04）

摘　　要：目的验证影响糖尿病足溃疡（diabetic foot ulcer，DFU）预后的相关因素。方法本前瞻性研究共纳入来自单一糖尿病足中心的186例Ⅱ型DFU患者，6个月内随访结局（愈合、大截肢、死亡）。通过Logistic多元回归分析DFU患者的人口学和临床资料与DFU结局之间的关系。结果随访172例DFU患者，其中147例愈合（包括55例小截肢后愈合），3例大截肢，6例死亡，16例在研究结束时仍未愈合。kgistic多元回归分析表明，缺血（P〈0．01）、感染（P〈0．05）、溃疡数目（P〈0．01）、周围神经病变（P〈0．05）可独立影响DFU结局；缺血[优势比（odds ratio，OR）=10．8]、感染（OR=211．4）、溃疡数目（OR=39．5）、周围神经病变（OR=181．1）增加DFU不良结局的风险。结论DFU的预后与缺血、感染、溃疡数目和周围神经病变有关。Objective To identify the factors related to prognosis of diabetic foot ulcer （DFU）. Methods A total of 186 patients with type Ⅱ DFU from a single diabetic foot center was included in this prospective study. Follow-up of the final outcome （healing, major amputation or death） was made in 6 months. Influence of patient demographics and clinical data on outcome was detected using multivariate Logistic regression analysis. Results Follow-up was performed in 172 patients, of whom 147 were cured （55 eases cured after minor amputations）, 3 underwent major amputations, 6 died, and 16 were not yet cured at the final follow-up. In multivariate Logistic regression analysis, the outcome was inde- pendently correlated with isehemia （ P 〈 0.01 ）, infection （ P 〈 0.05 ）, ulcer number （ P 〈 0.01 ） and peripheral neuropathy （ P 〈 0.05 ） ; the risk of poor outcome increased with ischemia [ odds ratio （OR） = 10.8 ], infection （ OR = 211.4）, ulcer number （ OR = 39.5 ）, and peripheral neuropathy （ OR = 181.1 ）. Conclusion Prognosis of DFU is associated with ischemia, infection, ulcer number, and peripheral neuropathy.

关 键 词：糖尿病足 预后 前瞻性研究 

分 类 号：R587.2[医药卫生—内分泌]