微循环功能检测与周围神经功能筛查对糖尿病足预测价值的比较  

Comparison of the Predictive Values of Microcirculation Function Testing and Peripheral Nerve Function Screening for Diabetic Foot

作　　者：李梦圆 马学娅 张小玉 谢晖 孙婷 鹿亮 余蕾 马祖长[2,4] LI Meng-yuan;MA Xue-ya;ZHANG Xiao-yu;XIE Hui;SUN Ting;LU Liang;YU Lei;MA Zu-chang(College of Nursing,Bengbu Medical University,Bengbu 233030,China;Institute of Intelligent Machines,Hefei Institutes of Physical Science,Chinese Academy of Sciences,Hefei 230031,China;University of Science and Technology of China,Hefei 230026,China;The First Affiliated Hospital of USTC,Hefei 230036,China)

机构地区：[1]蚌埠医科大学护理学院,蚌埠233030 [2]中科院合肥物质科学研究院智能所,合肥230031 [3]中国科学技术大学,合肥230026 [4]中国科学技术大学第一附属医院,合肥230036

出　　处：《微循环学杂志》2024年第4期38-44,共7页Chinese Journal of Microcirculation

基　　金：国家重点研发计划(2022YFC2010200);安徽省教育厅研究生教育质量工程项目(2022lhpysfjd063);蚌埠医学院2022年度研究生创新计划(Byycx22077)。

摘　　要：目的:分析并比较微循环功能检测和周围神经功能筛查对糖尿病足(DF)的预测价值。方法:纳入180名2型糖尿病(T2DM)患者,分为DF组(n=60)和NDF组(n=120)。对于周围神经功能,运用临床5项筛查以及震动感觉阈值(VPT)检测。针对微循环功能,采用激光多普勒血流仪进行测量,具体涵盖经皮氧分压(TcPO_(2))、阻断后反应性充血(PORH,主要观察参数为BZ-PF%)和局部热充血(LTH,主要观察参数为PU%)。通过多因素Logistic回归分别构建基于神经功能指标、微循环功能指标和神经功能+微循环指标的DF筛查模型,并比较模型对DF预测性能的差异。结果:基于微循环指标BZ-PF%构建的预测模型性能优于基于神经功能指标(临床5项筛查、VPT)构建的预测模型性能;两者联合指标中基于BZ-PF%+VPT预测模型性能达到最优,且BZ-PF%在该模型中的重要性优先于VPT。结论:微循环功能障碍和糖尿病周围神经病变(DPN)都是DF的重要影响因素,在DF预防领域关注周围神经病变的同时也不能忽视糖尿病患者微循环功能的变化。Objective:To analyze and compare the predictive values of microcirculation function test and peripheral nerve function screening for diabetic foot(DF).Method:A total of 180 patients with type 2 diabetes mellitus(T2DM)were enrolled and divided into the DF group(n=60)and the non-diabetic foot(NDF)group(n=120).For the peripheral nerve function,5-item clinical screening and vibration perception threshold(VPT)test were used.For the microcirculation function,a laser Doppler flowmeter was used for measurement,specifically including transcutaneous oxygen partial pressure(TcPO_(2)),post-occlusive reactive hyperemia(PORH,with the main observation parameter of BZ-PF%)and local thermal hyperemia(LTH,with the main observation parameter of PU%).Multivariate logistic regression was used to construct DF screening models based on nerve function indexes,microcirculation function indexes,and nerve function+microcirculation indexes respectively,and the differences in the predictive performance of the models for DF were compared.Results:The performance of the prediction model based on the microcirculation index BZ-PF%was better than that of the prediction models based on the nerve function indexes(5-item clinical screening,VPT);among the combined indexes of the two,the prediction model performance based on BZ-PF%+VPT was optimal,and the importance of BZ-PF%in this model was prior to that of VPT.Conclusion:Microcirculation dysfunction and diabetic peripheral neuropathy are both important influencing factors of DF.In the field of DF prevention,while paying attention to peripheral neuropathy,the changes in the microcirculation function of diabetic patients cannot be ignored.

关 键 词：2型糖尿病 糖尿病足 微循环参数 糖尿病周围神经功能指标 筛查效能 

分 类 号：R587.2[医药卫生—内分泌]