不同溃疡程度糖尿病足患者的临床特点及预后分析  

Clinical characteristics and prognosis of patients with different degree of diabetic foot ulcer

作　　者：王璐宁[1] 杨彩哲[1] 吴石白[1] Wang Luning Yang Caizhe Wu Shibai.(General Hospital of the Chinese People Air Force, Beijing 100142, China)

机构地区：[1]空军总医院内分泌科,北京100142

出　　处：《北京医学》2017年第3期257-260,共4页Beijing Medical Journal

摘　　要：目的总结糖尿病足的临床特点,分析预后。方法选择2013年9月至2015年9月住院治疗92例糖尿病足患者,按Wagner不同分级分组,对比各组患者入院时的一般情况、检查结果,记录患足创面3个月愈合率,分析不愈合原因。结果不同Wagner分级患者,年龄、糖尿病病程、糖尿病足溃疡持续时间、糖化血红蛋白、踝肱指数、血高密度脂蛋白、慢性肾脏病(CKD)3期以上比较,组间差异无统计学意义(P>0.05)。Wagner1级组创面持续时间较Wagner(2~5级)组短(P<0.05)。白细胞计数、C反应蛋白、血浆纤维蛋白原、血沉数值随着Wagner分级增加逐渐升高,血红蛋白、白蛋白、血胆固醇、血甘油三酯随着Wagner分级的增加逐渐降低,各组间差异有统计学意义(P均<0.05)。不同Wagner分级患足3个月愈合率组间差异有统计学意义(P<0.05)。结论可以由炎性和营养状态指标结合糖尿病足溃疡Wagner分级,评估患足感染、坏疽情况。患足血供和足部坏疽程度决定了患足的预后。Objective To study the clinical characteristics of diabetic foot ulcer and to assess the severity of the infection in the foot and the related prognosis. Methods A retrospective analysis of the clinical data of 92 diabetic foot patients, admitted from september 2013 to september 2015 was performed. According to Wagner classification system, the patients were divided into four groups. The clinical data and the wound healing rates of 3 months in the different groups were compared, the causes of the wound not healed were analyzed. Results There were no significant statistical differences in age, the duration of diabetes, Hb level, ankle brachial index（ABI）, HDL and stage 3 chronic renal disease（CKD） in the different groups. The foot ulcer duration of Wagner 1 grade was shorter than others（P〈0.05）. WBC, CRP, FIB, ESR increased and the Hb level, serum albumin, TC, TG declined with the increasing Wagner classification（P〈0.05）. The differences of wound healing rates of 3 months between groups were significantly different（P〈0.05）. Conclusion The severity of diabetic foot ulcer can be evaluated by Wagner classification, inflammatory and nutritional status. The severity of diabetic foot ulcer and peripheral artery disease determines the prognosis of foot.

关 键 词：糖尿病足 溃疡 感染 Wagner分级 

分 类 号：R587.2[医药卫生—内分泌]