糖尿病足伴周围动脉血管病变危险因素分析

Analysis of relative risk factors of patients with diabetic foot combined with peripheral arterial disease in type 2 diabetes mellitus

目的分析糖尿病足溃疡伴周围动脉病变(PAD)患者的临床特征和危险因素。方法回顾性分析收治的182例资料完整的住院糖尿病足(DF)患者,根据有无周围动脉病变分为有动脉病变组(92例)以及无动脉病变组(90例),分析其临床特征。结果伴PAD的DF患者的年龄较无PAD的DF患者更大、糖尿病病程较无PAD的患者更长(P<0.05),合并冠心病、糖尿病周围神经病变、骨髓炎、坏疽等的比例高于无PAD患者(P<0.05或P<0.01);入院时随机血糖、HbA1c及尿微量白蛋白、血尿酸水平均高于无PAD患者(P<0.05或P<0.01)。多因素非条件Logistic回归分析显示:年龄(OR=1.19,P=0.001)、冠心病(OR=1.65,P=0.003)、入院时随机血糖(OR=3.51,P=0.005)、HbA1c(OR=1.69,P=0.007)、坏疽(OR=3.24,P=0.043)、尿微量白蛋白(OR=1.15,P=0.031)、血尿酸(OR=2.13,P=0.019)是伴PAD的DF患者发生的重要危险因素。结论伴PAD的DF患者病变程度重,伴发症多;年龄、冠心病、入院时随机血糖、HbA1c、尿微量白蛋白和血尿酸水平是DF患者周围动脉病变发生的重要危险因素。

Objective To investigate the clinical characteristics and risk factors of peripheral arterial disease（PAD） in patients with diabetic foot（DF）.Methods 182 hospital patients with DF were enrolled.According to whether undergoing PAD,patients were divided into PAD group（n=92） and non-PAD group（n=90）.The clinical characteristics were retrospectively analyzed.Results Compared with non-PAD group,the age was older,the course of DM was longer,and the ratio of coronary artery disease,osteomyelitis,and gangrene were more frequent in PAD group than those in non-PAD group.The level of random blood glucose on admission,HbA1c,urine microalbumin and blood uric acid were higher in PAD group.Multifactorial unconditional logistic regression analysis showed that age,coronary artery disease,random glucose on admission,HbA1c,urine microalbumin and blood uric acid were the important risk factors of PAD in patients with DF.Conclusions In-hospital DF patients with PAD have more seriously conditions and complications.age,coronary artery disease,random glucose on admission,HbA1c,urine microalbumin and blood uric acid are the important risk factors of PAD in patients with DF.