糖尿病足患者临床特征及危险因素分析

Clinical features and risk factors of diabetic foot

目的回顾性分析糖尿病足患者临床资料,探讨糖尿病足患者临床特征及发病的危险因素。方法选择2012年4月—2015年5月眉山市中医医院收治的糖尿病足患者(n=100)与非糖尿病足(糖尿病未伴糖尿病足)患者(n=158),对比分析两组患者临床资料,采用多因素logistic回归分析糖尿病足患者发病的危险因素。结果糖尿病足组患者年龄、糖尿病病程、合并症发生率、白细胞计数、纤维蛋白原水平、糖化血红蛋白(glycated hemoglobin,HbA1c)水平、超敏C反应蛋白(high-sensitivity C-reactive protein,hs-CRP)水平明显高于非糖尿病足组(P<0.05);踝肱指数、血红蛋白、白蛋白水平低于非糖尿病足组(P<0.05)。糖尿病足独立危险因素为年龄、Wanger分级、Hb A1c、踝肱指数、hs-CRP、白蛋白(P<0.05);HbA1c、hs-CRP水平为糖尿病足患者病情严重程度独立危险因素;不同Wanger分级患者预后情况差异有统计学意义(Z=–4.394,P<0.001)。结论 Wanger分级越严重、年龄越大、hs-CRP与HbA1c水平越高、踝肱指数与白蛋白水平越低,糖尿病患者发生糖尿病足的风险越高,依据患者自身情况早期采取预防措施有利于防治糖尿病足截肢。

Objective To investigate the clinical features and risk factors of diabetic foot. Methods A total of 100 patients with diabetic foot and 158 diabetic patients without diabetic foot were selected from April 2012 to May 2015 in Meishan Hospital of Traditional Chinese Medicine. Clinical data of the patients in the two groups was comparatively analyzed. Multiple logistic regression analysis was used to explore the risk factors. Results The age, duration of diabetes, incidences of complications, count of white blood cells, level of fibrinogen, level of high-sensitivity C-reactive protein （hs- CRP） and level of glycated hemoglobin （HbAlc） in diabetic foot group were significantly higher than those in non- diabetic foot group （P〈0.05）, while the ankle-brachial index, level of hemoglobin and level of albumin in diabetic foot group were significantly lower than those in non-diabetic foot group （P〈0.05）. The independent risk factors of diabetic foot were Wanger grade, age, ankle-brachial index, hs-CRP, albumin and HbAlc （P〈0.05）. HbAlc and hs-CRP level were independent risk factors of disease severity in patients with diabetic foot; the difference of prognosis in patients with different Wanger grading was statistically significant （Z=-4.394, P〈0.001）. Conclusions The risk of diabetic foot in diabetic patients increases with older age, the more serious Wanger grade, the higher hs-CRP and HbAlc level, and the lower anlde-brachial index and albumin level. Taking precautions based on the patient＇s situation is conducive to early prevention of amputation in diabetic patients with diabetic foot.