糖尿病足的临床特点及危险因素分析  

Analysis of clinical characteristics and risk factors of diabetic foot

作　　者：谭小燕[1] 钟玫[1] 唐雪 黄秀禄[1] 农月稠[1] 玉颜庆[1] 莫健明[1] TAN Xiao-yan;ZHONG Mei;TANG Xue(Department of Endocrinology and Metabolism, the People′s Hospital of Guangxi Zhuang Autonomous Region, Nanning 530021, China)

机构地区：[1]广西壮族自治区人民医院内分泌代谢科,南宁530021

出　　处：《中国临床新医学》2022年第5期453-457,共5页CHINESE JOURNAL OF NEW CLINICAL MEDICINE

基　　金：广西医疗卫生适宜技术开发与推广应用项目(编号:S2017079);广西卫生健康委科研课题(编号:Z20180767,Z20180768)。

摘　　要：目的探讨糖尿病足(DF)的临床特点,分析糖尿病患者发生DF的危险因素,为制定预防DF发生的干预措施提供参考。方法回顾性分析2019年1月至2019年12月广西壮族自治区人民医院内分泌代谢科收治的730例糖尿病患者的临床资料,根据DF的发生情况将其分为DF组(88例)和非DF组(642例)。分析DF患者的临床特点,应用logistic回归模型分析影响DF发生的危险因素。结果与非DF组比较,DF组的糖尿病病程更长,白蛋白水平更低,肌酐和24 h尿白蛋白定量水平更高,伴发糖尿病肾病、视网膜病变、下肢血管病变、周围神经病变的人数比例更高,差异有统计学意义(P<0.05)。多因素logistic回归分析结果显示,伴发下肢血管病变是糖尿病患者发生DF的危险因素(OR=2.218),而较高水平的白蛋白是抑制糖尿病患者发生DF的保护因素(OR=0.901)。DF患者患足的胫部踝臂指数(ABI)、跖骨旁经皮氧分压(TcPO_(2))和局部灌注指数水平均低于对侧健足,差异有统计学意义(P<0.05)。结论伴发下肢血管病变和较低的血清白蛋白水平是糖尿病患者发生DF的危险因素。对伴有高危因素的糖尿病患者应加强预防DF的宣传教育,提高患者的风险意识和自我保健能力,预防DF的发生。Objective To explore the clinical characteristics of diabetic foot(DF),to analyze the risk factors of DF in diabetic patients,and to provide reference for formulating intervention measures to prevent the occurrence of DF.Methods The clinical data of 730 diabetic patients admitted to Department of Endocrinology and Metabolism,the People′s Hospital of Guangxi Zhuang Autonomous Region from January 2019 to December 2019 were retrospectively analyzed.According to the occurrence of DF,the patients were divided into DF group(88 cases)and non-DF group(642 cases).The clinical characteristics of the DF patients were analyzed,and the risk factors affecting the occurrence of DF were analyzed by using logistic regression model.Results Compared with the non-DF group,the DF group had a longer course of diabetes,lower albumin level,higher quantitative level of 24-hour urine albumin,and a higher proportion of patients with accompanied diabetic nephropathy,retinopathy,lower extremity vascular disease,and peripheral neuropathy,and the differences were statistically significant(P<0.05).Multivariate logistic regression analysis showed that the accompanied lower extremity vascular disease was a risk factor for DF in diabetic patients(OR=2.218),and a higher level of albumin was a protective factor to inhibit the occurrence of DF in diabetic patients(OR=0.901).For the DF patients,the tibial ankle-brachial index(ABI),parametatarsal transcutaneous oxygen partial pressure(TcPO_(2))and local perfusion index of the affected foot were lower than those of the healthy foot in the opposite side,and the differences were statistically significant(P<0.05).Conclusion Accompanied lower extremity vascular disease and lower level of serum albumin are the risk factors for DF in diabetic patients.For the diabetic patients with high-risk factors,publicity and education on the prevention of DF should be strengthened to improve the risk awareness and self-care ability of the patients to prevent the occurrence of DF.

关 键 词：糖尿病足 特征 危险因素 

分 类 号：R587.2[医药卫生—内分泌]