2型糖尿病患者糖尿病足合并骨髓炎发生的危险因素分析

Analysis on Risk Factors for Diabetic Foot and Osteomyelitis in Patients with Type 2 Diabetes Mellitus

目的探讨2型糖尿病(T2DM)患者糖尿病足合并骨髓炎发生的相关危险因素。方法选择2014年1月至2016年12月住院治疗的T2DM合并糖尿病足患者152例,根据是否合并骨髓炎分为骨髓炎组(54例)和非骨髓炎组(98例),回顾性分析两组患者的一般资料、实验室检查资料、糖尿病足溃疡严重程度等,采用二分类Logistic回归分析筛选糖尿病足合并骨髓炎的危险因素。结果骨髓炎组的CRP、血清白蛋白、 HbA1c水平及糖尿病病程≥10年比例、下肢动脉病变比例、混合病原菌感染比例均高于非骨髓炎组(P <0.05)。二分类Logistic回归分析显示, HbA1c (OR=1.141, 95%CI:1.007～1.292)、病程≥10年(OR=2.371, 95%CI:1.043～5.392)、混合病原菌感染(OR=2.582, 95%CI:1.128～5.909)是糖尿病足合并骨髓炎的独立危险因素(P <0.05)。结论对于糖尿病病程长、血糖控制差、溃疡创面混合病原菌感染的人群,应做好分级管理,加强健康教育和病情监测,预防骨髓炎的发生。

Objective To explore the relative risk factors of diabetic foot and osteomyelitis in patients with type 2 diabetes mellitus(T2DM). Methods 152 cases of T2 DM patients with diabetic foot hospitalized from January 2014 to December 2016 were selected and divided into osteomyelitis group(54 cases) and non-osteomyelitis group(98 cases) according to whether they were complicated with osteomyelitis. Clinical data, laboratory examination data and severity of diabetic foot ulcers of the two groups were retrospectively analyzed.Binary Logistic regression analysis was used to identify the risk factors of diabetic foot complicated with osteomyelitis. Results The CRP,serum albumin and HbA1c levels, and the rates of diabetic duration ≥10 years, lower extremity arterial disease and mixed pathogen infection in osteomyelitis group were significantly higher than those in non-osteomyelitis group(P<0.05). Binary Logistic regression analysis showed that HbA1c(OR=1.141, 95%CI: 1.007 ~ 1.292), diabetic duration ≥10 years(OR=2.371, 95%CI: 1.043 ~ 5.392) and mixed pathogen infection(OR=2.582, 95% CI: 1.128 ~ 5.909) were the independent risk factors for diabetic foot complicated with osteomyelitis(P<0.05). Conclusions For patients with long diabetic duration, poor glycemic control and mixed pathogen infection of ulcer wound, conducting hierarchical management, strengthening health education and condition monitoring should be well prepared, so as to prevent the occurrence of osteomyelitis.