糖尿病足溃疡临床特点及其危险因素分析  

Analysis of clinical characteristics and risk factors of diabetic foot ulcer

作　　者：陶世冰[1] 唐晓初[1] 高俊梅[1] 邹兰灵 李丽英[1] 唐霞琳 

机构地区：[1]资阳市第一人民医院内分泌科,四川资阳641300

出　　处：《慢性病学杂志》2015年第3期295-297,300,共4页Chronic Pathematology Journal

基　　金：四川省卫生厅科研立项项目(120010)

摘　　要：目的探讨糖尿病足溃疡(DFU)的临床特点,分析其严重程度的危险因素。方法回顾分析90例DFU患者的临床特点,采用多因素Logistic回归分析影响DFU严重程度的危险因素。采用SPSS 19.0统计软件,计量资料以(x±s)表示,比较采用两独立样本t检验;计数资料率的比较采用x^2检验。P≤0.05为差异有统计学意义。结果 DFU患者年龄(68.03±14.85)岁,52例痊愈(57.78%),31例好转(34.44%),7例未愈(7.78%)。DFU发病有明确诱发因素26例(28.89%),无明确诱因64例(71.11%)。并发糖尿病周围神经病73例(81.11%)、糖尿病外周动脉病变72例(80.00%)、糖尿病肾病45例(50.00%)、糖尿病眼病41例(45.56%),合并吸烟31例(34.44%)、冠心病29例(32.22%)、脑梗死33例(36.67%)、高血压43例(47.78%)、高脂血症24例(26.67%);不同Wagnet分级DFU患者并发症及心血管疾病发生率比较差异均无统计学意义(均P>0.05)。DFU严重程度的危险因素有性别、农村医保、吸烟、糖尿病外周动脉病变、冠心病、脑梗塞、血脂异常、年龄、糖尿病病程(P均<0.05)。结论加强对糖尿病患者血糖的管理,及时干预各种心血管危险因素,加强对DFU早期神经病变、血管病变的筛查和高危人群的教育,预防DFU发生,改善预后,避免截肢。Objective To explore clinical features and to analyze risk factors for the occurrence and development of diabetic foot ulcer(DFU).Methods The clinical characteristics of 90 cases of patients with DFU were analyzed retrospectively.Risk factors for severe DFU were analyzed using multivariate logistic regression models.SPSS 19.0 was used in this study.Continuous variables were described using mean + sd and compared between groups using t— test.Categorical variables were compared between groups using Chi—Square test.P<0.05 was considered as statistic significant.Results The average age of patients was(68.03±14.85)years.52(57.78%) cases were cured;31(34.44%) cases showed improvement;7(7.78%) cases did not show any improvement.26(28.89%) cases had clear risks before occurrence of the disease,but 64(71.11%) cases did not show significant risks.DFU patients also had a variety of complications:73(81.11%) patients with diabetic peripheral neuropathy,72(34.44%) patients with diabetic peripheral artery disease(DPA),45(50.00%) patients with diabetic nephropathy,and 41(45.56%) patients with diabetic ophthalmopathy.There were also high prevalence rates for other risks and diseases including 34.44%(31 cases) for smoking,32.22%(29 cases) for coronary heart diseases,36.67%(33 cases) for cerebral infarction,47.78%(43 cases) for hypertension,and 26.67%(24 cases)for hyperlipidemia.The differences of complication prevalence rates and cardiovascular disease prevalence rates between different Wagner grade groups were not significant.Regression analysis showed that the risks for severe DFU including gender,rural medical insurance,smoking,DPA,coronary heart dis—ease,cerebral infarction,dyslipidemia,age,and duration of diabetes(P<0.05).Conclusions The management of blood glucose among diabetic patients should be improved.Prevention for risk factors of cardiovascular disease should be conducted early.In order to prevent DFU and to avoid amputation,screenings for early neuropathy and vascular diseases should be improved and health edu

关 键 词：糖尿病 糖尿病足 溃疡 

分 类 号：R587.2[医药卫生—内分泌]