中国开封汉族2型糖尿病足住院患者的死亡率——一项回顾性队列研究  

Mortality of hospitalised Han Chinese patients with type 2 diabetic foot ulcers in Kaifeng,China:a retrospective cohort study

作　　者：李欢 吕玉泉 刘若璇 吴家齐 刘永恩 马东平 周粤闽 LI Huan;LYU Yuquan;LIU Ruoxuan;WU Jiaqi;LIU Yongen;MA Dongping;ZHOU Yuemin(Department of Plastic Surgery,Yihe Hospital of Henan University,Zhengzhou 450000,CHN;College of Nursing and Health,Henan University,Kaifeng 475000,CHN;International Joint Laboratory for Cell Medical Engineering of Henan Province,Kaifeng 475000,CHN;Dpartment of Plastic and Reconstructive Surgery,Huaibe Hospital of Henan University,Kaifeng 475000,CHN;Department of Cardiology,Huaihe Hospital of Henan University,Kaifeng 475000,CHN)

机构地区：[1]郑州颐和医院整形外科,郑州450000 [2]河南大学护理学院,河南开封475000 [3]河南省细胞医学工程国际联合实验室,河南开封475000 [4]河南大学淮河医院整形修复外科,河南开封475000 [5]河南大学淮河医院心内科,河南开封475000

出　　处：《河南大学学报（医学版）》2023年第4期261-269,共9页Journal of Henan University:Medical Science

基　　金：河南大学研究生英才计划(SYL19060148)。

摘　　要：目的:研究2型糖尿病足(T2DF)患者的死亡率和死亡危险因素。方法:将符合条件的309名T2DF患者(168名男性、141名女性)纳入并完成研究(有效率:71.7%),采用Cox比例风险回归模型分析计算风险比和95%置信区间,生成整个研究人群的累积Kaplan-Meier生存曲线,以及年龄、Wagner分级、心血管疾病、糖尿病肾病、周围神经病变的生存曲线。结果:309名患者共随访948.7人年,其中147名患者死亡,死亡率为15.5/100人年。累积死亡率为47.6%,中位随访时间为2.7年(P25,P75=1.2年,4.4年)。多变量Cox比例回归分析显示,高龄(校正后的HR=1.80,95%CI=1.28~2.54;P=0.001),Wagner分级≥4级(校正后的HR=2.56,95%CI=1.81-3.63;P<0.001)、心血管疾病(校正后的HR=1.92,95%CI=1.33~2.77;P=0.001)和糖尿病肾病(校正后的HR=1.68,95%CI=1.18~2.39;P=0.004)是独立的死亡风险因素(TVC试验,P>0.05)。结论:T2DF患者死亡率较高,死亡风险增加与年龄、Wagner分级、心血管疾病和糖尿病肾病明显相关,与糖尿病神经病变呈负相关。Objective:To determine the rate and predictors of mortality in patients with type 2 diabetic foot ulcer(T2DFU)followed-up as inpatients in Huaihe hospital of Henan University.Methods:309 patients with T2DFU(168 men,141 women)were included and completed the study(response rate:71.7%).Cox proportional hazards regression analysis was used to calculate the hazards ratio(HR)and 95%confidence interval(CI).We generated cumulative Kaplan-Meier survival curves for the entire study population as well as groups stratified by age,Wagner grade,CVD,DN,and PN.Results:309 patients were followed-up for a total of 948.7 person-years,147 died,resulting in a mortality rate of 15.5 per 100 person-years.The cumulative mortality rate was 47.6%over a median follow-up period of 2.7 years(25th-75th percentile=1.2~4.4 years).Advanced age(adjusted hazard ration=1.80,95%confidence interval=1.2~-2.54;P=0.001),Wagner grade≥4(adjusted HR=2.56,95%CI=1.81~3.63;P<0.001),cardiovascular disease(CVD;adjusted HR=1.92,95%CI=1.33~2.77;P=0.001),and diabetic nephropathy(adjusted HR=1.68,95%CI=1.18~2.39;P=0.004)were identified as positive independent predictors of mortality(TVC test,P>0.05).Conclusion:Patients with T2DFU had a high mortality rate.Age,Wagner grade,CVD,and diabetic nephropathy,but not peripheral neuropathy,were associated with an increased risk of early death.

关 键 词：死亡率 2型糖尿病 糖尿病足 死亡危险因素 汉族 

分 类 号：R62[医药卫生—整形外科]