糖尿病足溃疡患者愈合后1年内复发的风险列线图构建  

Construction of a nomogram of the risk of recurrence within 1 year after healing of diabetic foot ulcers

作　　者：徐艳 刘倩柳 操凌雁 Xu Yan;Liu Qianliu;Cao Lingyan(Wound and Stomy Clinic,Huaining Hospital,Anqing Municipal Hospital,Anqing 246121,China)

机构地区：[1]安庆市立医院怀宁院区伤口造口门诊,246121 [2]安庆市立医院怀宁院肿瘤科,246121

出　　处：《中华保健医学杂志》2024年第3期336-339,共4页Chinese Journal of Health Care and Medicine

基　　金：合肥市应用医学研究项目(Hwk2021zd007)。

摘　　要：目的 分析糖尿病足溃疡患者愈合后复发情况,并根据影响因素构建风险列线图模型。方法 回顾性选取2019年4月~2022年4月安庆市立医院怀宁院区收治的经住院治疗糖尿病足溃疡愈合的150例糖尿病患者,并根据随访1年内是否复发糖尿病足溃疡将分为复发组与未复发组。采用单因素分析及多因素分析logisitic回归对影响糖尿病足溃疡患者愈合后复发相关因素进行分析,并基于此构建风险预测模型绘制列线图。结果 150例患者随访1年后,失访10例,最后共收集140例患者数据,随访完成率为93.3%,其中糖尿病足溃疡复发54例,复发率为38.57%。logisitic回归分析结果显示,年龄、吸烟史、胼胝、初发为足底溃疡、足部畸形、糖化血红蛋白、C反应蛋白是糖尿病足溃疡复发的独立危险因素(OR> 1,P<0.05),白蛋白是糖尿病足溃疡复发的独立保护因素(OR<1,P<0.05)。以此构建风险预测模型,Hosemer-Lemeshow拟合优度检验:χ^(2)=5.597,P=0.756;ROC曲线下面积为0.987(95%CI=0.973~0.999,P<0.001),灵敏度和特异度分别为91.9%、98.1%。结论 糖尿病足溃疡患者愈合后复发受多重因素共同影响,依据危险因素构建的预测模型具有良好的预测效果。Objective To analyze the recurrence of diabetic foot ulcers after healing and construct a risk nomogram model based on influencing factors.Methods A total of 140 diabetic patients who had healed from foot ulcers and were admitted to our hospital from April 2019 to April 2022 were selected as the research objects.Patients were divided into recurrence group(n=54)and non-recurrence group(n=86)according to whether diabetic foot ulcer recurred within 1 year of follow-up.Univariate and multivariate logistic regression analyses were performed to identify factors influencing the recurrence of diabetic foot ulcer after healing.Based on these findinds,a risk prediction model was constructed,and a nomogram was drawn.Results The follow-up completion rate was 93.3%,and the recurrence rate of diabetic foot ulcer within 1 year was 38.57%.Logistic regression analysis showed that age,smoking history,callus,initial plantar ulcer,foot deformity,glycosylated hemoglobin,and C-reactive protein were independent risk factors for the recurrence of diabetic foot ulcer(OR>1,P<0.05),and albumin was an independent protective factor for the recurrence of diabetic foot ulcer(OR<1,P<0.05).Hosemer-Lemeshow goodness-of-fit test:χ^(2)==5.597,P=0.756.The area under the ROC curve was 0.987(95%CI=0.973~0.999,P<0.001),and the sensitivity and specificity were 91.9%and 98.1%,respectively.Conclusion The recurrence of diabetic foot ulcers after healing is affected by multiple factors.The risk prediction model based on these factors demonstrates a good predictive performance.

关 键 词：糖尿病足溃疡 愈合后复发 危险因素 预测模型 

分 类 号：R587[医药卫生—内分泌]