糖尿病足严重程度危险因素分析

The Analysis of Severity of diabetic foot risk factors

目的:了解糖尿病足(DF)不同分期之间的差异,并认识随溃疡严重程度加剧的因素变化,认识坏疽、截肢的危险因素变化。方法:选择2009年1月~2010年4月期间在我院住院的糖尿病足患者90名,根据病足严重程度,分为坏疽组(3~5级)及非坏疽组(1~2级),坏疽组患者53名,非坏疽组患者37名。对其临床资料进行分析,探讨坏疽发生的危险因素,包括性别、年龄、体重指数(BM I)、血压(BP)、空腹血糖(FBG)、餐后2h血糖(PBG)、糖化血红蛋白(HbAlc)、空腹血脂谱(包括血浆胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C))、血肌酐(SCR)、血尿素氮(BUN)、白蛋白、纤维蛋白原(FIB),是否合并高血压史、吸烟史、脑梗塞、冠心病、糖尿病周围神经病变、糖病肾病、外周血管病变等,进行了分析。结果:两组比较甘油三酯、白蛋白、纤维蛋白原有显著差异,坏疽组甘油三酯、白蛋白偏低,纤维蛋白原偏高。多元逐步回归分析显示HbA1c、低白蛋白、纤维蛋白原、SCR与DF坏疽发生呈正相关。结论:高糖化血红蛋白、低白蛋白、高纤维蛋白原、高血肌酐是DF坏疽发生的危险因素。

Objective： To Investigate the risk factors for diabetic foot were analyzed. The Protoeol for preventing and treating diabetic foot can be done. Methods： 90 Patients with diabetic foot in our hospital from August, 2007 to August, 2008, were obserdved.Theses Patients were divided into gangrene gronp （n=53）and non-gangrene group（n=37）, measurement data was used to analyze. Multiple stepwiseregression analysis was used to analyze the data with difference. The risk factors for diabetic foot gangrene were observed,including sex, age,the index of body weight（BMI）, blood p^ssure（BP）, ast blood glueose（FBG）, post prandial bloodglueose（PBG）, glyeatedhemoglobin（HbAlc）, eholesterol（TC）, triglyceride（TG）, high density lipoprotein（HDL-C）, low density lipoprotein（LDL-C）, serumereatinine（Cr）, blood ufia nitrogen（BUN）, history of cerebral infaretion, history of hypertension and smoking, coronary heart disease, diabetic neuropathy, diabetic nepphropathy, peripheral vaseular diseases. Results： There were different between the two groups with triglyceride （TG） and albumin and fibrinogen signiiieantly, triglyceride （TG） and albumin were lower in gangrene group, and fibrinogen was higher Multiple stepwiseregression analysis show, the gangrene of diabetie foot was signifieantly correlated with HbAlc, low-albumin？fibdnogen. Conclusion：High HbAlc？ low- albumin？High fibrinogen, High nitrogen are the risk factors for gangrene of diabet.