糖尿病足患者下肢血管病变分析

Analysis of lower extremity vascular disease in patients with diabetic foot

目的调查和分析糖尿病足下肢血管病变特点及相关因素。方法回顾性分析本院2008年1月～2012年1月门诊和住院收治的糖尿病患者200例临床资料,根据是否合并糖尿病足分为两组,无糖尿病足患者100例为对照组,合并糖尿病足患者100例作为观察组,对所有患者进行病史回顾、体格检查、生化检查及下肢血管检查和周围神经检查,分析影响下肢病变的相关因素。结果观察组年龄、高血压病程、BMI、腰臀比、收缩压、舒张压等指标与对照组比较差异无统计学意义(P>0.05);观察组糖尿病病程明显长于对照组,且差异有统计学意义(P<0.05);足部缺血性溃疡患者足病中位病程[(6.4±1.2)个月]明显长于神经性溃疡患者[(3.6±0.7)个月](P<0.01),混合性溃疡患者足病中位病程为(13.5±4.2)个月,长于单纯神经性溃疡患者及缺血性溃疡患者(均P<0.01),缺血性足病组及混合性足病组溃疡深度明显较深。结论糖尿病足溃疡患者中缺血性溃疡及混合性溃疡多见,下肢血管病变发病率高;缺血性溃疡溃疡深,愈合慢,截肢(趾)率高,预后差,足部神经病变与缺血病变相互影响加重足病病情,ABI检查是糖尿病足下肢血管病变简单实用的检查方法。

Objective To survey and analyze characteristics and related factors of lower extremity vascular disease of diabetic foot. Methods Clinical data of 200 diabetes outpatient and inpatient admitted to our hospital from January 2008 to January 2012 was retrospectively analyzed, all patiants divided into two groups according to whether with merger diabetic foot or not, 100 patients without diabetic foot as control group, 100 patients with diabetes foot as ob- servation group , all patients were given history review, physical examination, biochemical tests, lower extremity vascu- lar checks and surrounding nerve examination, to analyze the relevant factors affecting the lower extremity lesions. Results The age, duration of hypertension, BMI, waist-to-hip ratio, systolic blood pressure, diastolic blood pressure and other indicators of observation group and control group compared, the difference was not significant （ P 〉 0.05 ）; diabetes duration of the observation group was significantly longer than that of control group, and the difference was significant （1~ 〈0.05）; Median duration of foot ischemic ulcers in patients with foot disease [（6.4±1.2） months ] was sig- nificantly longer than patients with neuropathic ulcers[（3.6±0.7） months] （P 〈 0.01）, Median duration of patients with mixed ulcers podiatric [（13.5±4.2） months] was longer than patients with pure neuropathic ulcers, ischemic ulcers （P 〈 0.01）. The ulcer depth of ischemic foot disease group and mixed podiatric group significantly deeper. Conclusion Is- chemic ulcers and mixed ulcers in diabetic foot ulcers patients are more common, incidence of lower extremity vascu- lar disease is high; ulcer depth of ischemic ulcers ulcer is deep and heal slowly, amputation （toe） rate is high, the prognosis is poor. The interactions of foot neuropathy and ischemic lesions aggravate the condition of podiatric ABI check is simple and practical inspection methods for lower extremity vascular disease in diabetic foot.