基于ZIS-PROTECT研究的老年糖尿病足高危人群筛查分析  

Screening analysis of high-risk population of elderly diabetes foot based on ZIS-PROTECT study

作　　者：王一峰 丁诚 董智慧 薛丽 WANG Yifeng;DING Cheng;DONG Zhihui;XUE Li(General Practice Department of Zhangyan Community Health Service Center of Jinshan District,Shanghai 201514,China;General Practice Department of Lvxiang Community Health Service Center of Jinshan District,Shanghai 201517,China;Department of Vascular Surgery of Zhongshan Hospital Affiliated to Fudan University,National Clinical Research Center for Radiology and Therapy,Shanghai 200032,China)

机构地区：[1]上海市金山区张堰镇社区卫生服务中心全科医疗科,上海201514 [2]上海市金山区吕巷镇社区卫生服务中心全科医疗科,上海201517 [3]复旦大学附属中山医院血管外科,国家放射与治疗临床医学研究中心,上海200032

出　　处：《上海医药》2024年第22期30-33,48,共5页Shanghai Medical & Pharmaceutical Journal

基　　金：2020年度金山区医药卫生类创新资金项目(2020-3-53)。

摘　　要：目的:分析2型糖尿病患者糖尿病足高危人群筛查结果,了解2型糖尿病人群中周围神经、血管病变的患病率及其影响因素。方法:选择上海金山区吕巷镇社区卫生服务中心在册管理的60岁及以上2型糖尿病患者312名,经知情同意后参加ZIS PROTECT研究。运用糖尿病足筛查盒、足部三维扫描仪、足底压力测量仪进行筛查,并分析合并影响糖尿病足的因素。结果:周围神经病变检出率为7.37%,下肢动脉病变检出率为5.77%,两者联合病变的检出率为1.28%。糖尿病足高危总检出率为14.42%。高危组患者的病程、臀围、肾功能(血清肌酐、血清尿素氮)、血清白蛋白、糖化血红蛋白明显增高(P<0.05)。二元logistic回归分析结果显示,病程(OR:1.059,95%CI:1.014~1.106)、年龄(OR:1.063,95%CI:1.004~1.125)、血清白蛋白(OR:0.895,95%CI:0.802~0.998)与糖尿病足高危相关。结论:糖尿病足高危人群筛查中,下肢血管超声检查不可或缺;患病病程、年龄是糖尿病足高危的危险因素,血清白蛋白是糖尿病足高危的保护因素。Objective:To analyze the screening results of the diabetes foot high-risk population with type 2 diabetes patients,to understand the prevalence of peripheral nerve,and vascular disease and influence factors in diabetes population.Methods:Three hundred and twelve patients aged 60 and above with type 2 diabetes who were registered and managed by Lvxiang Community Health Service Center of Jinshan District,Shanghai were selected.After obtaining informed consent,the patients participated in the ZIS PROTECT study.The diabetes foot screening box,foot 3D scanner,and foot pressure measuring device were used for screening and analyzing the combined factors affecting diabetes foot.Results:The detection rate of peripheral neuropathy was 7.37%,the detection rate of lower limb artery disease was 5.77%,the detection rate of mixed lesions was 1.28%.The total detection rate of diabetes foot high-risk was 14.42%.The prevalence of age,hip circumference,renal function(serum creatinine and serum urea nitrogen),serum albumin and glycosylated hemoglobin in the high risk group of diabetes foot was significantly higher(P<0.05).The results of binary logistic regression analysis showed that the years of illness(OR:1.059,95%CI:1.014-1.106),age(OR:1.063,95%CI:1.004-1.125),and albumin(OR:0.895,95%CI:0.802-0.998)were related to high risk of diabetes foot.Conclusion:Ultrasonic examination of lower limb blood vessels is indispensable in screening high-risk population of diabetes foot;the years of illness,and age are the diabetes foot high-risk factors,serum albumin is the protecting factors for the diabetes foot high-risk.

关 键 词：2型糖尿病 老年人 慢性并发症 糖尿病足 筛查 

分 类 号：R587.2[医药卫生—内分泌]