糖尿病足感染并发全身炎症反应综合征危险因素分析  

Evaluation of risk factors in diabetic foot infections with systemic inflammatory response syndrome

作　　者：赵婕 王爱红[1] 王斌[1] 李萌萌[1] 李莉琼 魏晓伟 Zhao Jie;Wang Aihong;Wang Bin;Li Mengmeng;Li Liqiong;Wei Xiaowei(Department of Endocrinology,the Ninth Medical center 0f Chinese PLA General Hospital,Beijing 100101,China)

机构地区：[1]解放军总医院第九医学中心内分泌科,北京100101

出　　处：《中华医学杂志》2024年第47期4303-4307,共5页National Medical Journal of China

摘　　要：目的探讨糖尿病足感染(DFI)并发全身炎症反应综合征(SIRS)的危险因素。方法回顾性分析2021年1月至2023年12月在解放军总医院第九医学中心因DFI住院的301例患者的临床资料,其中男223例,女78例,年龄为(63.3±12.0)岁。按照是否发生SIRS分为SIRS组(n=32例)和非SIRS组(n=269例)。采用多因素logistic回归模型分析DFI合并SIRS的危险因素。结果SIRS组与非SIRS组患者比较,年龄更小[(60.3±8.5)比(63.7±12.3)岁,P=0.047],血清白蛋白[M(Q_(1),Q_(3))][32.7(29.3,37.3)比36.2(33.6,39.2)g/L,P=0.003]和血红蛋白[116.0(99.8,125.3)比121.0(111.0,136.0)g/L,P=0.022]水平更低,糖化血红蛋白[9.8%(8.7%,11.6%)比8.7%(7.4%,10.6%),P=0.007]更高;既往糖尿病足病史比例更低[25.0%(8/32)比46.8%(123/269),P=0.019],合并骨髓炎比例更高[90.6%(29/32)比46.7%(168/269),P=0.002]。多因素logistic回归分析结果显示,糖化血红蛋白升高(OR=1.27,95%CI:1.03~1.58)和骨髓炎(OR=4.5,95%CI:1.20~16.86)是并发SIRS的危险因素。结论血糖控制不佳和骨髓炎是DFI并发SIRS的危险因素。Objective To explore the risk factors of systemic inflammatory response syndrome(SIRS)in diabetes foot infection(DFI).Methods A retrospective analysis was conducted on the clinical data of 301 patients admitted to the Ninth Medical Center of the People′s Liberation Army General Hospital for DFI from January 2021 to December 2023,including 223 males and 78 females with the age of(63.3±12.0)years.The study population was divided into SIRS group(n=32)and non‑SIRS group(n=269)based on whether SIRS occurred.Multivariate logistic regression model was used to analyze the risk factors of DFI combined with SIRS.Results Compared with non‑SIRS group,patients in SIRS group were younger[(60.3±8.5)vs(63.7±12.3)years,P=0.047],with lower serum albumin[M(Q_(1),Q_(3))][32.7(29.3,37.3)vs 36.2(33.6,39.2)g/L,P=0.003]and hemoglobin[116.0(99.8,125.3)vs 121.0(111.0,136.0)g/L,P=0.022],and higher glycosylated hemoglobin[9.8%(8.7%,11.6%)vs 8.7%(7.4%,10.6%),P=0.007];positive rate of diabetes foot history was lower[25.0%(8/32)vs 46.8%(123/269),P=0.019]and the proportion of combined osteomyelitis was higher[90.6%(29/32)vs 46.7%(168/269),P=0.002]in SIRS group.Multivariate logistic regression analysis showed that elevated glycosylated hemoglobin(OR=1.27,95%CI:1.03-1.58)and osteomyelitis(OR=4.5,95%CI:1.20-16.86)were risk factors for SIRS.Conclusion Poor blood glucose control and osteomyelitis are risk factors for DFI complicated with SIRS.

关 键 词：糖尿病足 全身炎症反应综合征 骨髓炎 危险因素 

分 类 号：R587.2[医药卫生—内分泌]