常见临床指标与糖尿病足溃疡的相关性分析  

Correlation Analysis between the Common Clinical Indexes and Diabetic Foot Ulcer

作　　者：周舒婕 赵玲[1] 柯亭羽[1] ZHOU Shujie;ZHAO Ling;KE Tingyu(Dept.of Endocrinology,The 2nd Affiliated Hospital of Kunming Medical University,Kunming Yunnan 650106,China)

机构地区：[1]昆明医科大学第二附属医院内分泌科,云南昆明650106

出　　处：《昆明医科大学学报》2024年第1期61-66,共6页Journal of Kunming Medical University

基　　金：国家自然科学基金资助项目(82201475);昆明医科大学研究生创新基金资助项目(2023S089)。

摘　　要：目的 通过横断面研究探索常见临床指标与2型糖尿病(T2DM)患者并发糖尿病足溃疡(DFU)情况之间的关系,为临床DFU的监测、预后评估等提供参考指标。方法 以昆明医科大学第二附属医院内分泌科2021年6月至2023年6月收治的115例T2DM患者为研究对象,根据是否合并DFU分为A组(合并DFU)和B组(不合并DFU),再将A组患者根据Wagner分级分为A1组(Wagner0-1级)、A2组(Wagner2-3级)、A3组(Wagner4级)。比较各组患者一般资料及血压、血糖、血脂等常见临床指标的差异,探究DFU与上述指标的相关性。结果 A组患者糖尿病病程、D-二聚体(DD)、收缩压值等指标大于B组患者,差异具有统计学意义(P <0.05),其中DD是T2DM患者发生DFU的主要危险因素。DFU患者的DM病程与年龄成正相关(r> 0,P <0.05),与空腹血糖(FPG)水平、餐后2 h血糖(2hPG)水平成负相关(r <0,P <0.05)。A1、A2 2组的白细胞介素-6(IL-6)、C反应蛋白(CRP)均小于A3组,A1组的中性粒细胞、白细胞水平小于A3组,A1组的高密度脂蛋白胆固醇(HDL-C)大于A2组,差异均具有统计学意义(P <0.05)。结论 DD、收缩压是DFU发生的主要危险因素,DD与DFU的联系密切。年龄越大的T2DM患者DFU发病越晚;血糖控制越差,DFU发病越早。HDL-C是T2DM患者周围血管病变的保护因素。Objective To analyze the relationship between the common clinical indicators and diabetic foot ulcer(DFU)in type 2 diabetes mellitus(T2DM)patients by using the cross-sectional study and to provide the reference indicators for clinical DFU monitoring and prognosis evaluation.Methods A total of 115 T2DM patients admitted to the Department of Endocrinology,the Second Affiliated Hospital of Kunming Medical University from June 2021 to June 2023 were selected as the study objects and were divided into group A(with DFU)and group B(without DFU)according to whether they had DFU.Those in group A were then divided into group A1(Wagner0-1),group A2(Wagner2-3)and group A3(Wagner4)according to Wagner classification.The differences of general data,blood pressure,blood glucose,blood lipids and other common clinical indicators among all of the groups were compared,and the correlation between DFU and the above indicators was explored.Results Diabetes duration,D-dimer(DD),systolic blood pressure and other indexes in group A were higher than those in group B and there was a statistically significant difference(P<0.05).DD was the main risk factor for DFU in T2DM patients.Diabetic course in patients with DFU was positively correlated with the age(r>0,P<0.05),and negatively correlated with fasting blood glucose(FPG)level and 2hPG level at 2 hours after meals(r<0,P<0.05).The levels of interleukin-6(IL-6)and C-reactive protein(CRP)in A1 and A2 groups were lower than those in A3 group,the levels of neutrophils and leukocytes in A1 group were lower than those in A3 group,and the high density lipoprotein cholesterol(HDL-C)in A1 group was higher than that in A2 group and there was a statistically significant difference(P<0.05).Conclusion DD and systolic blood pressure are the main risk factors for DFU,and DD is closely related to DFU.The older the patients with T2DM,the later the onset of DFU.The worse the blood glucose control,the earlier the onset of DFU.HDL-C is a protective factor for peripheral vascular disease in T2DM patients.

关 键 词：2型糖尿病 糖尿病足溃疡 危险因素 

分 类 号：R587.2[医药卫生—内分泌]