下肢动脉病变评分与糖尿病足1年截肢率的相关性研究

Relationship between angiographic evaluation of peripheral arterial occlusive disease and amputation in diabetic foot

目的观察糖尿病足(DF)患者下肢血管病变(PAD)情况,分析DF发病1年内发生截肢的相关危险因素。方法住院2型糖尿病合并糖尿病足患者共95例加入研究。追踪观察1年,根据是否发生截肢分成两组:发生各种程度的截肢22例(包括肢端完全坏死)为截肢组,未发生截肢的73例患者为无截肢组。入院患者均询问其病史、治疗情况、慢性并发症,并测定血压、体质量指数等。抽取静脉血检测血糖(空腹及餐后)、糖化血红蛋白(HbA1C),并行血脂分析和检测尿微量白蛋白浓度等。应用螺旋CT血管成像技术(CTA)评估住院DF患者下肢动脉病变情况。所有患者均检查髂总动脉、髂外动脉、股浅动脉、动脉、胫前动脉、胫后动脉、腓动脉和足背动脉,并按评分标准评分。糖尿病足诊断按照Wagner标准。结果在因糖尿病足住院患者中,1年内截肢率为23.2%,logistic回归分析结果表明,糖尿病足1年内发生截肢的危险因素有:PAD评分(OR=1.2,P=0.012)、合并感染(OR=4.2,P=0.027)、既往截肢(OR=5.8,P=0.017)等。结论PAD评分、合并感染和既往截肢是糖尿病足截肢的独立危险因素。

Objective To determine the relationship between angiographic evaluation of peripheral arterial occlusive disease and amputation in diabetic foot.Methods There were 95 patients involved in this study.All the patients were divided into two groups after 1 year′s observation according to with or without amputation.The diabetic patients were interviewed about duration,treatment profile,presence or absence of chronic DM complications,prior amputation,blood pressure,height,and body mass index(BMI).Fasting blood sa...