营养指标与糖尿病足严重程度相关性分析

Analysis of Correlation between Nutritional Indicators and Severity of Diabetic Foot

目的分析糖尿病足患者营养状态与糖尿病足发生发展的关系。方法纳入2014年至2015年我院内分泌科收治的糖尿病足患者147例作为研究对象并进行Wagner诊断分级。选择年龄、性别、病程相匹配的同期收治的2型糖尿病非糖尿病足患者作为对照组。收集患者的一般资料及实验室指标,采用SPSS18.0分析不同Wagner诊断分级患者各营养指标的趋势变化。用Logistic多因素回归分析糖尿病足与各变量间的关系。结果两组患者比较糖尿病足组BMI、Hb、Alb、TC、TG、HDL-C、LDL-C差异均有统计学意义(P<0.05)。按照Wagner诊断分级对糖尿病足患者进行分级,其中1级患者11例,2级患者55例,3级患者39例,4级患者34例,5级患者8例。随着Wagner分级的增高,BMI(F=19.5,P<0.05)、Hb(F=12.1,P<0.05)、Alb(F=23.1,P<0.05)、TG(F=34.1,P<0.05)、HDL-C(F=13.2,P<0.05)呈下降趋势,LDL-C(F=51.3,P<0.05)升高趋势。Logistic回归分析,结果显示BMI、Hb、Alb、HDL-C为糖尿病足发生的保护因素。结论积极进行营养支持,尤其是纠正低白蛋白血症,对于糖尿病足的防治有积极的意义。

Objective To analyze the relationship between the nutritional status of patient who has diabetic foot and the development of diabetic foot. Methods A total of 147 diabetic patients admitted to our hospital from 2014 to 2015 were enrolled in the study and were diagnosed according to Wagnerclassification grade. The patients （admitted to our hospital at the same time） with type 2 diabetes mellitus but had no diabetic footwere selected as the control group,with age, sex, course of disease adapting to the experiment group. The general data and laboratory parameters of the patients were collected and the trend change of the nutri- tional indicators of different Wagner group patients was analyzed by SPSS18. 0. Logistic multivariate regression was used to analyze the relationship between diabetic foot and the variables. Results The differences of BMI, Hb, Alb,TC,TG, HDL-C and LDL-C be- tween the two groups were statistically significant（P 〈 0. 05 ）. According to Wagner diagnostic classification,patients with diabetic foot including 11 patients in grade 1,55 patients in grade 2,39 patients in grade 3,34 patients in grade 4,8 patients in grade 5. With the Wagner grade increased, BMI （ F = 19. 5, P 〈 0. 05 ）, Hb （ F = 12. 1, P 〈 0. 05 ）, Alb （ F = 23.1, P 〈 0. 05 ）, TG （ F = 34. 1, P 〈 0.05 ）, HDL-C （ F = 13.2, P 〈 0. 05 ） showed a downward trend and LDL-C （ F = 51.3, P 〈 0.05 ） showed a rising trend. Logistic regression analysis showed that BMI, Hb, Alb and HDL-C were protective factors for diabetic foot. Conclusion Positive nutritional support, especially correcting hypoalbuminemia, has a positive significancefor the prevention and treatment of diabetic foot.