社区老年糖尿病足的危险评估与分析

Assessment and analysis of risk factors for diabetic foot in elderly in the community

目的了解老年糖尿病足危险等级情况,并分析其影响因素。方法纳入社区内年龄≥60岁、Wagner分级为0级的老年糖尿病患者339例。根据苏格兰糖尿病足危险因素评估法对所有患者进行糖尿病足危险程度分级,同时采用多普勒周围血管检查仪进行足部血流情况的探测。结果 339例老年糖尿病患者中,低危足者237例(69.9%),中危足者73例(21.5%),高危足者29例(8.6%);糖尿病病程和踝动脉峰值流速是老年糖尿病足发生的独立预测因子(P<0.001,P<0.026)。结论注重老年糖尿病足部情况的评估,尤其对病程长、踝动脉峰值流速情况不佳者,关注足部血流动力学的变化,积极采用控制血糖和改善下肢微循环等干预措施,减少糖尿病足的危险因素,防止老年糖尿病足的发生与发展。

Objective To assess the level of risk factors for diabetic foot in the elderly diabetic patients and analyze its influencing factors. Methods 339 subjects, aged sixty years old or above and graded 0 by Wagner diabetic foot classification, were recruited. All of these patients were graded according to Scottish Foot Ulcer Risk Score and examined the blood flow of feet using Doppler Blood Analyzer. Results In 339 elderly diabetics, 237 cases were at low risk accounted for 69.9%, 73 at moderate risk for 21.55 %, and 29 at high risk for 8.6 %. Meanwhile, diabetic duration and the peak flow velocity of ankle artery were independent predictors of diabetic foot （P〈0.001, P〈0.026）. Conclusion Strengthen assessment of feet in elderly diabetics, especially patients with long diabetic duration and poor foot artery blood flow, and pay attention to changes of foot hemodynamic. Moreover, some measures should be taken to prevent the occurrence or development of diabetic foot in elderly diabetic patients, such as controlling blood sugar, improving the microcirculation of lower extremity positively and so on, to reduce risk factors for diabetic foot in elderly.