Wagner3-5级老年糖尿病足部溃疡患者不同愈合程度与C肽的关系

Relationship between different healing degree and C peptide in elderly patients with Wagner3-5diabetic foot ulcers

目的:探讨Wagner3-5级老年糖尿病足部溃疡患者不同愈合程度与C肽的关系。方法:选取我院241例Wagner3-5级糖尿病足部溃疡患者,根据患者住院记录统计患者性别、年龄、糖尿病病程、住院天数、BMI等。入院后完善各项检查。包括血常规和血生化,尿常规,肝肾功;对所有患者进行为期5年的随访,在随访结束后溃疡未愈合的患者定义为不良预后组,溃疡愈合的患者定义为预后良好组,单因素分析探讨影响DFU患者愈合的因素,Cox比例风险模型进一步评价有统计学意义的所有因素对DFU患者愈合的影响程度;运用ROC曲线分析具有统计学意义的因素,计算曲线下面积,以评价其对DFU患者愈合的预测能力。结果:随访结束时,失访患者6例,出现终点事件的有177人,愈合率为73.44%;单因素多因素分析显示,糖尿病病程和HbA1C是影响预后的独立危险因素;FCP是影响预后的独立保护因素;糖尿病病程在ROC曲线下的AUC为0.754,HbA1C在ROC曲线下的AUC为0.791,FCP水平ROC曲线下的AUC为0.581。结论:FCP低是DFU患者愈合的独立危险因素,但是FCP其对于患者愈合的预测效果并不明显。

Objective: To explore the relationship between different healing degree and C peptide in elderly patients with diabetic foot ulcers. Methods: A total of 241 DFU patients treated in our hospital from September 2, 2011 to September 2, 2012. were selected. After admission, patients' sex, age, the course of diabetes, length of hospitalization, and BMI were counted. After examination, blood routine and blood biochemistry, urine routine, hepatorenalresultswere recorded.A cording to5-year follow up, patients with unhealed ulcers were defined as bad prognosis group during follow-up, and patients with ulcerative healing were defined as good prognosis group. Single factor analysis was applied to analyze factors affecting the healing of DFU patients;Cox proportional risk model was used for further evaluation ofthe effect of all factors with statistical significance on the healing of DFU patients. ROC curve was used to analyze the statistically significant factors and to calculate the area under the curve in order to evaluate the predictive ability of these factors in the prognosis ofDFU. Results: At the end of the follow-up period, 6 patients were lost to be followed, 177 had the end point event, and the healing rate was 73.44%. Single factor and multifactor analysis showed that the course of diabetes and HbA1C were independent risk factors affecting the prognosis. FCP was an independent protective factor affecting the prognosis. ROCanaysis showed for the factor ofcourse of diabetes the area was 0.754 under the ROC curve,the area under the ROC curve for HbA1C was 0.791, while the AUC of FCP level was 0.581 under the ROC curve, which was lower than the former two factors. Conclusion: Low FCP is an independent risk factor for DFU healing, but FCP has little predictive effect on patient healing.