HDL-C与糖尿病足截肢术后30天死亡的相关性分析  

Correlation between HDL-C and 30 day mortality after amputation of diabetes foot

作　　者：许细某 吴雅娴 叶伟斌 XU Ximou;WU Yaxian;YE Weibin(Department of Anesthesiology,Sun Yat-sen Memorial Hospital,Sun Yat-sen University,Guangzhou,Guangdong 510100,China)

机构地区：[1]中山大学孙逸仙纪念医院麻醉科,广东广州510100

出　　处：《中国医学工程》2023年第11期94-97,共4页China Medical Engineering

摘　　要：目的糖尿病足患者常合并多种基础疾病,截肢术后死亡风险较高。本研究主要探讨糖尿病足患者术前高密度脂蛋白胆固醇(HDL-C)水平是否能预测截肢术后30 d全因死亡风险。方法回顾性分析2017年7月至2022年3月于中山大学孙逸仙纪念医院因糖尿病足行截肢手术的患者。研究对象临床资料收集齐全,术前行血常规、生化、血脂等实验室检查。术后均完成随访,通过住院病历或电话随访获取患者术后30 d的生存状态。根据患者术后30 d的生存状态,分为死亡组及存活组。结果本研究共纳入114例患者,死亡组患者18例(15.8%),存活组96例(84.2%)。与存活组相比,死亡组的HDL-C水平更低,低HDL-C患者的白细胞、降钙素原水平更高,差异均有统计学意义(P<0.05)。在多元Logistic回归分析中,HDL-C(O^R=0.025,95%CI=0.001~0.800,P=0.037)是截肢术后30 d死亡的独立预测因素。结论在糖尿病足患者中,低HDL-C水平是截肢术后30 d全因死亡的独立危险因素,对于术后短期不良预后有重要的预测价值。【Objective】Diabetes foot patients are often complicated with many basic diseases,and the risk of death after amputation is high.This study was to investigate whether preoperative high-density lipoprotein cholesterol(HDL-C)levels in patients with diabetes foot can predict the risk of all-cause death 30 days after amputation.【Methods】From July 2017 to March 2022,the patients who underwent amputation of diabetes foot in Sun Yat-sen Memorial Hospital of Sun Yat-sen University were retrospectively analyzed.The clinical data of the research subjects was fully collected,and laboratory examinations such as blood routine,biochemistry,and blood lipids were conducted before surgery.Follow up was completed after surgery,and the survival status of the patients was obtained 30 days after surgery through inpatient medical records or telephone follow-up.According to the survival status of the patient 30 days after surgery,they were divided into a death group and a survival group.【Results】A total of 114 patients were included in this study,including 18 patients in the death group(15.8%)and 96 patients in the survival group(84.2%).Compared with the survival group,the HDL-C level in the death group was lower(P=0.005).Patients with low HDL-C had higher levels of white blood cells(P=0.010)and procalcitonin(P=0.001).In multiple logistic regression analysis,HDL-C(OR=0.025,95%CI=0.001–0.800,P=0.037)was an independent predictor of mortality at 30 days after amputation.【Conclusion】In patients with diabetes foot,low HDL-C level is an independent risk factor for all-cause death 30 days after amputation,and has important predictive value for short-term adverse prognosis after amputation.

关 键 词：高密度脂蛋白胆固醇 糖尿病足 脓毒血症 截肢 不良预后 

分 类 号：R587.2[医药卫生—内分泌]