2型糖尿病患者糖尿病足的相关危险因素分析

The analysis of risk factors for diabetic foot in type 2 diabetic patients

目的：探讨2型糖尿病患者糖尿病足的患病情况及其相关危险因素，为临床治疗和预防唐尿病足提供依据。方法：选择2006年2月～2007年2月住院的2型糖尿病患者627例为研究对象，按照有无合并糖尿病足分为2组，回顾性分析其性别、年龄、病程、吸烟史、体重指数、腰围、入院时的血压、既往高血压病史及其病程、空腹血糖、餐后2h血糖、糖化血红蛋白、甘油三酯、总胆固醇、高密度脂蛋白、低密度脂蛋白、血尿酸、血肌酐、尿素氮、血清总蛋白、白蛋白，以及尿蛋白情况、糖尿病肾病、糖尿病视网膜病变等因素。结果：糖尿病足所占比例为19．6％。糖尿病足组与非糖尿病足组相比，年龄、病程、收缩压、餐后2h血糖、糖化血红蛋白、血肌酐、尿素氮、血清总蛋白、白蛋白、尿蛋白、糖尿病肾病、糖尿病视网膜病变等因素差异均有统计学意义（P〈0．05）。糖尿病病程、白蛋白、糖尿病肾病3个因素进入回归模型并具有统计学意义（P〈0．05）。结论：年龄、糖尿病病程、血糖控制情况、血清蛋白水平、尿蛋白情况、糖尿病肾病等因素与糖尿病足的发生有关，其中糖尿病病程、低白蛋白血症及糖尿病肾病是糖尿病足的独立危险因素。

Objective： To investigate the proportion of diabetic foot in patients with type 2 diabetes mellitus （T2DM）, and to analyze the risk factors for diabetic foot. Methods： Six hundred and twenty seven inpatients with T2DM from February 2006 to February 9007 were interviewed, According to whether the patients had diabetic foot or not, they were derided into two groups. All the probable risk factors were collected, including sex, age, course, body mass index （BMI）, blood pressure （BP： SBP/DBP）, the duration of hypertension and smoking, fasting plasma glucose （FPG）, 2 hour postprandial plasma glucose （2 h PG）, glycated hemoglobin A1C（HbA1C）, total cholesterol （TC）, triglyceride （TG）, high density lipoprotein-cholesterol （HDL C）, low density lipoprotein-cholesterol （LDL-C）, serum creatinine （Scr）, blood urea nitrogen （BUN）, uric acid, total protein, albumin, urine protein including urine albumin excretion rate（UAE） and quantization of urine protein in 24 hours, diabetic nephropathy, diabetic retinopathy. Results： This investigation showed the proportion of diabetic foot in patients with T2DM was 19.6 %. The occurrence of diabetic foot was correlated with age, course, SBP, 2 h PG, HbA1C, Scr, BUN, total protein, albumin, urine protein, diabetic nephropathy, diabetic retinopathy （P 〈0.05）. The occurrence of diabetic foot was significantly correlated with years of T2DM, albumin and diabetic nephropathy （P 〈0.05）. Conclusion： Albumin, years of T2DM and diabetic nephropathy are the independent risk factors for diabetic foot.