奥扎格雷治疗老年糖尿病足患者的临床疗效及影响复发的相关因素分析  

Clinical efficacy of Ozagrel in the treatment of elderly patients with diabetic foot and analysis of related factors affecting recurrence

作　　者：邬亦华 王瑞良[2] 顾晔 石晓欣[2] Wu Yihua;Wang Ruiliang;Gu Ye;Shi Xiaoxin(Endocrinology Department,Shanghai International Medical Center,Shanghai 201318,China)

机构地区：[1]上海国际医学中心内分泌科,上海201318 [2]上海交通大学医学院附属新华医院老年科 [3]上海国际医学中心内科

出　　处：《海军医学杂志》2021年第1期90-93,共4页Journal of Navy Medicine

摘　　要：目的探究奥扎格雷治疗老年糖尿病足患者的临床疗效,并分析影响其复发的相关因素。方法收集2014年1月至2017年3月于上海国际医学中心接受奥扎格雷治疗的糖尿病足患者118例。观察并记录治疗后患者的临床效果。对治愈的患者进行为期2年的随访,了解患者的复发情况,分析影响老年糖尿病足治愈后复发的影响因素。结果经过治疗,糖尿病足治疗的总有效率为93.22%,治愈2年后复发率为22.73%。单因素分析结果显示,复发组Wagner分级、吸烟、糖尿病足病程、多重耐药菌感染、周围神经病变、周围血管病变、是否彻底清创和未复发组比较差异有统计学意义(P<0.05),复发组性别、年龄、糖尿病病程、体质量指数(BMI)、高血压、糖尿病肾病、高血脂和未复发组比较差异无统计学意义(P>0.05);Logistic回归分析结果显示,Wagner分级为Ⅲ级、多重耐药菌感染、周围神经病变、周围血管病变、未彻底清创是老年糖尿病足复发的独立危险因素(P<0.05)。结论奥扎格雷治疗老年糖尿病足安全有效。糖尿病足的远期复发率较高,应对患者进行早期全面分级评估、彻底清创,对具有复发高危因素的患者需严格控制血糖,提高机体免疫力,防止复发。Objective To explore the clinical efficacy of Ozagrel in the treatment of elderly patients with diabetic foot,and to analyze related factors affecting recurrence.Methods 118 patients with diabetic foot treated with Ozagrel in the Shanghai International Medical Center from January 2014 to March 2017 were recruited for study,and clinical efficacy was closely observed and recorded.The patients had 2-year medical follow-up to see if there was recurrence among them,and also to analyze the factors influencing the recurrence of the disease in elderly patients.Results After treatment,total effective rate was 93.22%with a relapse rate of 22.73%after 2 years.Single-factor analysis results showed that statistical significance could be noted in Wagner grading,smoking,diabetes foot course,multiple drug-resistant bacteria infection,peripheral neuropathy,peripheral vasculopathy and thorough debridement,when the recurrent group was compared with its counterpart(P<0.05).However,there was no statistical significance in gender,age,diabetes course,body mass index(BMI),hypertension,diabetic renopathy and hyperlipidemia,when comparisons were made between the 2 groups(P>0.05).Logistic regression analysis indicated that Wagner gradeⅢ,multiple drug-resistant bacteria infection,peripheral neuropathy,peripheral vasculopathy and incomplete debridement were independent risk factors for recurrence in elderly patients with diabetic foot(P<0.05).Conclusion Ozagrel is safe and effective in the treatment of elderly patients with diabetic foot.The late relapse rate of diabetic foot is relatively high.Patients should be evaluated in an early and comprehensive manner and thorough debridement should be complemented.Patients with high risk factors of recurrence should strictly control serum sugar level,so that immunity could be enhanced and recurrence be prevented.

关 键 词：老年 糖尿病足 奥扎格雷 疗效 复发 相关因素 

分 类 号：R453.9[医药卫生—治疗学] R587.2[医药卫生—临床医学]