基于多中心的中国糖尿病足患者临床资料分析  

Clinical analysis for patients with diabetic foot among multiple centers in China

作　　者：许景灿[1] 王娅平[1] 陈燕[2] 蔡蕴敏[3] 刘敏[4] 周秋红[5] XU Jingcan;WANG Yaping;CHEN Yan;CAI Yunmin;LIU Min;ZHOU Qiuhong(Department of Nursing,Xiangya Hospital,Central South University,Changsha 410008;Orthopedic Center,Ningbo NO.2 Hospital,Ningbo Zhejiang 315010;Wound Healing Center,Jinshan Hospital Affiliated to Fudan University,Shanghai 200540;Department of Endocrinology,West China Hospital,Sichuan University,Chengdu 610041;Department of Endocrinology,Xiangya Hospital,Central South University,Changsha 410008,China)

机构地区：[1]中南大学湘雅医院护理部,长沙410008 [2]宁波市第二医院骨科中心,浙江宁波315010 [3]复旦大学附属金山医院门诊换药室,上海200540 [4]四川大学华西医院内分泌科,成都610041 [5]中南大学湘雅医院内分泌科,长沙410008

出　　处：《中南大学学报（医学版）》2019年第8期898-904,共7页Journal of Central South University ：Medical Science

摘　　要：目的:通过多中心横断面调查探讨现阶段糖尿病足患者的临床特征、危险因素和影响病情严重程度的因素。方法:采用统一制定的糖尿病足患者临床资料收集表,于2017年10月至11月收集全国13家三级综合医院326例糖尿病足患者(男205例,女121例)的临床资料,分析其临床特征,并采用logistic回归分析发生重型糖尿病足的影响因素。结果:在326例糖尿病足患者中,68.4%的患者年龄>60岁,60.1%的患者文化程度为小学或初中;96.3%的糖尿病足发生于2型糖尿病患者,80.1%的糖尿病足患者糖化血红蛋白A1c(glycated hemoglobin,HbA1c)≥7%,60.1%的患者血脂代谢异常。鞋袜穿着不当(38.5%)为发生糖尿病足的主要诱因。其并发症以糖尿病神经病变(76.7%)、糖尿病视网膜病变(62.3%)和下肢血管病变(57.4%)最为多见。Logistic回归分析显示:糖尿病肾病、糖尿病下肢血管病变、HbA1c水平为发生重型糖尿病足的独立危险因素,接受足部护理教育为其保护因素。结论:糖尿病足多发于男性、年龄偏大、文化程度低、血糖控制差、血脂异常的2型糖尿病患者。其发生常有诱因,并伴有糖尿病并发症。糖尿病肾病、糖尿病下肢血管病变、HbA1c和接受足部护理教育为糖尿病足严重程度的独立影响因素。Objective: To explore the clinical characteristics,risk factors and factors aff ecting the severity of the disease in patients with diabetic foot at the current stage through a multi-center cross-sectional survey. Methods: Clinical data of 326 patients with diabetic foot (205 males and 121 females) from 13 general hospitals nationwide were collected from October to November 2017 using a unified clinical data collection table.The clinical characteristics were analyzed,and the influential factors for severe diabetic foot were analyzed by logistic regression analysis. Results: Among 326 patients with diabetic foot,68.4% of the patients were more than 60 years old, and 60.1% of the patients received primary or junior high school education;96.3% of the patients developed Type 2 diabetes;80.1% of patients had glycated hemoglobin (HbA1c)≥7%;60.1% of patients suffered dyslipidemia.Improper wearing of footwear (38.5%) is the main cause of diabetic foot.Diabetic neuropathy (76.7%),diabetic retinopathy (62.3%) and lower limb vascular disease (57.4%) were the most common complications.Logistic regression analysis showed that diabetic nephropathy,diabetic lower extremity vascular disease,and HbA1c levels were independent risk factors for severe diabetic foot,and receiving foot care education can be regarded as a protective factor. Conclusion: The diabetic foot occurs mostly in male patients,and Type 2 diabetes with older age,lower education level,poor glycemic control and dyslipidemia are the risk factors.Diabetic nephropathy,diabetic lower extremity vascular disease,HbA1c,and receiving foot care education are independent influential factors for the severity of diabetic foot.

关 键 词：糖尿病足 临床特征 Wagner分级 多中心横断面调查 

分 类 号：R587.2[医药卫生—内分泌]