糖尿病足的危险因素分析

Analysis of risk factor of diabetic foot

目的探讨糖尿病足发生的危险因素，以指导临床筛查糖尿病足高危人群，做到早期发现，早期预防，早期治疗，以降低糖尿病足和截肢的发生率。方法收集在我院内分泌科住院的糖尿病足患者23名（DF组）和随机选择同期住院的85名非糖尿病足患者（NDF组）的临床资料，包括性别、年龄、糖尿病病程、体重指数（BMI）、收缩压（SBP）、舒张压（DBP）、既往吸烟史、是否合并视网膜病变（DR）、肾脏病变（DN）、高血压、冠心病（CHD）、脑梗死（cD、TG、TC、低密度脂蛋白胆固醇（LDL—c）、极低密度脂蛋白胆固醇（VLDL—C）、空腹血糖（FBG）、餐后2h血糖（PBG）、糖化血红蛋白（GHbAlc）进行分析。结果DF组患者的年龄、糖尿病的病程和男性所占比例高于NDF组，差异有统计学意义（P〈0，05）；两组的吸烟率差异无统计学意义（P〉0．05）。DF组合并DR、DN、CHD的发生率高于NDF组；合并高血压、cI，两组差异无统计学意义。DF组患者的收缩压明显高于NDF组（P〈0．05）；两组患者的舒张压、体重指数比较差异无统计学意义（P〉0．05）。DF组空腹血糖、糖化血红蛋白明显高于NDF组，差异有统计学意义（P〈0．05）；两组的血脂（TG，TC，LDL—C，VLDL—c）、餐后2h血糖比较差异无统计学意义（P〉0．05）。经过多元逐步非条件Logistic回归分析，提示男性、糖化血红蛋白和收缩压增高是糖尿病足发生的危险因素。结论在社区人群中，倡导健康合理的膳食习惯，控制血压、血糖是预防2型糖尿病和糖尿病足发生的重要措施。

Objective To analyses the risk factors of diabetic foot, in order to direct clinical doctors to screen the patient with high risk factors of diabetic foot （DF）, discover DF early, prevent and cure it early, which has the important significance in decreasing the morbility of DF and amputation. Methods The clinical data of 23 in patients with DF （DF group） hospitalized in endocrine department and 85 in diabetic patients （NDF group） hospital- ized in the same period were collected. The data was observed including sex, age, the duration of disease, BMI,SBP, DBP,the history of hypertension and smoking, complication of diabetic nephropathy （DN）, diabetic retinopathy （DR）, coronary artery disease （CHD） and cerebral infarction （CI）, TG, TC, low density lipoprotein cholesterol （ LDL - C）, very low - density lipoprotein cholesterol （ VLDL - C ）, fasting blood glucose （ FBG）, postprandial blood glucose （PBG）, glycosylated hemoglobin （GHbAlc）. Results Compared with the NDF group, the patients＇ age was older and the duration of diabetes was longer in DF group （P 〈 0. 05 ）, proportion of male was also different （P 〈0. 05）, the rate of somking was no significant difference （P 〉0. 05）. Patients who complicated with CHD, DN and DR were more in DF group （P 〈 0. 05）, the morbidity of hypertension and CI were no significant difference be- tween the DF group and the NDF group （P 〉 0. 05）. Compared with the NDF group, FBG and GHbAlc were higher in the DF group （P 〈 O. 05 ）, the level of blood lipid （ including TG, TC, LDL - C, VLDL - C） and PBG had no significant statistical difference （P 〉 0. 05）. Man,SBP,GHbA1 c were the risk factors of DF according to the logistic regression analysis. Conclusion It was an important measure to prevent type 2 DM in community population to propose healthy life style including proper diet , control of blood glucose and blood pressure.