糖尿病足溃疡患者糖化血红蛋白与创面愈合的相关性分析  

作　　者：胡家[1] 霍丽霞 张玲[1] 叶蕾[1] 倪林[1] 

机构地区：[1]浙江省湖州市第一人民医院,313000

出　　处：《浙江临床医学》2020年第7期1005-1007,共3页Zhejiang Clinical Medical Journal

基　　金：浙江省医药卫生科技计划项目(2020KY310);浙江省湖州市科技计划项目(2017GYB15)。

摘　　要：目的随访并定期监测糖尿病足溃疡(DFU)患者的糖化血红蛋白(HbA1c),分析糖化血红蛋白相关指标与糖尿病足溃疡愈合的相关性.方法收集105例DFU住院患者的临床资料:包括糖尿病用药,并发症,基线HbA1c等.随访糖尿病足溃疡患者的溃疡创面愈合与糖化血红蛋白相关指标变化的相关性.结果随访期间每隔3个月检测HbA1c,随访HbA1c与预期HbA1c比值为1.0.创面溃疡治疗期间,最低HbA1c为6.9%,较基线的中位变化为20.1%.平均糖化血红蛋白中位数为7.5%,较基线的中位变化19.8%.在调整模型中,基线糖化血红蛋白与创面愈合无关.基线HbA1c<7.5%的受试者中,基线HbA1c最低值变化范围分层结果与区间(0.1~2.1)相比,(-1.5^-0.4)区间提示基线HbA1c最低值此范围与长期伤口愈合呈正相关(HR2.10,95%CI 1.05~3.92),但该组HbA1c的平均变化与创面愈合无相关性.结论在DFUs患者中,基线或预期HbA1c与伤口愈合间无临床意义的关联.在血糖基线控制较好的参与者中,伤口愈合加速与糖化血红蛋白较基线降低相关.Objective To followed up the patients with type 2 diabetes foot ulcer and regularly monitored Hemo^obin Alc.To investigate the association of Hemoglobin Ale(HbAlc)and wound Healing outcomes in Diabetic Foot Ulcers(DFU).Methods The clinical data of 105 inpatients with DFU were collected,including diabetes duration,comorbidities,baseline HbAlc,mean HbAlc,Nadir HbAlc,Target HbAlc ect.The DFU patients were followed up on the outcomes of ulcers and the index of HbAlc.Results HbAlc was detected every 3 months during the follow-up period.The ratio of HbAlc to the expected HbAlc was 1.0.The median nadir A1C during wound treatment was 6.9%,represented a median change from baseline of 20.1%.The median of the mean A1C was 7.5%,represented a median change from baseline of 19.8%.Baseline HbAlc was not associated with wound healing in univariate or fully adjusted models.Compared with a nadir HbAlc change from baseline of[-1.5 to-0.4],a nadir HbAlc change of[0.1 to 2.1]was positively associated with long term wound healing in the subset of participants with baseline HbAlc<7.5%(hazard ratio[HR],2.10,95%Cl,1.05〜3.92),but no association with wound healing was seen with the mean HbAlc change from baseline in this group.Conclusions There does not appear to be a clinically meaningful association between baseline or prospective HbAlc and wound healing in patients with DFU.However,accelerated wound healing is associated with the decrease in HbAlc from baseline HbAlc in the better glycemic control of DFU patients.

关 键 词：2型糖尿病 糖尿病足溃疡 糖化血红蛋白 创面愈合 

分 类 号：R58[医药卫生—内分泌]