初发糖尿病足溃疡患者的生存预后研究  

Survival outcomes of 522 hospitalized patients with new-onset diabetic foot ulcers

作　　者：莫泽纬[1] 陈道雄[1] 全会标[1] 陈开宁[1] 高勇义[1] 王斐[1] 陈存仁[1] 张华川[1] Ze-wei Mo;Dao-xiong Chen;Hui-biao Quan;Kai-ning Chen;Yong-yi Gao;Fei Wang;Cun-ren Chen;Hua-chuan Zhang(Department of Endocrinology,Hainan Provincial People’s Hospital,Haikou,Hainan 570311,China)

机构地区：[1]海南省人民医院内分泌科,海南海口570311

出　　处：《中国现代医学杂志》2018年第28期77-84,共8页China Journal of Modern Medicine

基　　金：海南省卫生计生行业科研项目(No:15A200084)

摘　　要：目的研究初发糖尿病足溃疡患者生存预后及影响生存预后因素。方法选取2010年1月-2016年12月于该院住院的609例初发糖尿病足溃疡(DFU)患者,随访至2017年6月,以获得生存状况及死亡时间。结果 522例(85.7%)完成随访,平均(3.475±1.690)年;存活288例(55.2%),死亡234例(44.8%);平均生存时间(4.720±0.120)年,中位生存期5.030年,1、3和5年累积生存率分别为89.8%、72.5%和50.4%。与存活组比较,死亡组患者年龄大、糖尿病病程长、足部病变程度重,糖尿病肾病、周围动脉病变、心血管病患病率高,差异有统计学意义(P<0.05)。年龄、Wagner分级、糖尿病肾病、周围动脉病变、心血管病是DFU患者死亡的高危因素。结论糖尿病患者初发足溃疡时已合并多种糖尿病慢性并发症及合并症,病死率高,平均生存期短,应对死亡高危因素进行早期干预。Objective To investigate the survival outcomes of 522 type 2 diabetic patients with new-onset diabetic foot ulcers(DFU).Methods A total of 609 cases of type 2 diabetic patients with new-onset foot ulcers admitted to Hainan Provincial People’s Hospital from January 2010 to December 2016 were followed up till June 2017.Their survival status and death time were recorded.Results Of the 609 patients,522(85.7%)patients fully experienced the follow-up,with a mean follow-up period of(3.475±1.690)years.Among the 522 patients,288 patients(55.2%)survived,234 patients(44.8%)died.The mean survival time was(4.72±0.12)years,and the median survival time was 5.03 years,and the 1-,3-and 5-year cumulative survival rates were 89.8%,72.5%and 50.4%respectively.Compared with the survival group,the patients in the deceased group had older age,longer diabetic duration,much more serious foot situations,higher incidences of diabetic nephropathy,peripheral arterial disease and cardiovascular disease(P<0.05).Age,Wagner grade,diabetic nephropathy,peripheral arterial disease and cardiovascular disease were the risk factors for death in the DFU patients.Conclusions Diabetic patients with newonset foot ulcers have multiple diabetic complications,high mortality and short average lifetime.Early interventions should be taken to deal with the mortality risk factors.

关 键 词：糖尿病足溃疡 生存预后 生存率 死亡高危因素 

分 类 号：R587.1[医药卫生—内分泌]