社区老年糖尿病患者足背经皮氧分压现况研究

Dorsal transcutaneous oxygen pressure of foot in community elederly DM patients

目的观察分析社区2型糖尿病(T2DM)患者足背经皮氧分压(TcPO2)水平。方法选择在北京市方庄和望京社区卫生服务中心就诊的T2DM且无糖尿病足患者270例,分别测量入选患者左、右侧足背TcPO2,并且以TcPO260mm Hg(1mm Hg=0.133kPa)为界,将至少一侧足背TcPO2<60 mm Hg为降低组214例(79.3%),其余为正常组56例。收集2组患者相关资料,进行二分类logistic回归分析。结果与正常组比较,降低组女性(61.2%vs 35.7%,P=0.001)和双下肢感觉异常(35.0%vs 17.9%,P=0.014)比例更高、高血压病程[(15.8±11.7)年vs(11.2±7.6)年,P=0.029]和血脂异常时间[(9.9±7.4)年vs(7.7±5.1)年,P=0.048]更长,差异有统计学意义。二分类logistic回归分析显示,女性(OR=2.831,95%CI:1.517~5.285,P=0.001)和双下肢感觉异常(OR=2.229,95%CI:1.047~4.748,P=0.038)为患者TcPO2降低的影响因素。结论社区老年T2DM无糖尿病足患者的足背TcPO2降低发生率高,TcPO2可能发现患者亚临床的足部组织灌注改变状况。

Objective To analyze the dorsal transcutaneous oxygen pressure(TcPO2)of foot in community elderly T2DM patients.Methods Two hundred and seventy T2DM patients without diabetic foot admitted to Beijing Fangzhuang Community Heath Service Center and Wangjing Community Heath Service Center were divided into dorsal TcPO2 of foot<60 mm Hg group(n=214)and normal dorsal TcPO2 of foot group(n=56).Their clinical data were recorded and analyzed by binary logistic regression analysis.Results The ratio of female patients and the incidence of abnormal lower extremity sensation were higher,the courses of hypertension and dyslipidemia were longer in dorsal TcPO2 of foot<60 mm Hg group than in normal dorsal TcPO2 of foot group(61.2%vs 35.7%,P=0.001;35.0%vs 17.9%,P=0.014;15.8±11.7 years vs 11.2±7.6 years,P=0.029;9.9±7.4 years vs 7.7±5.1 years,P=0.048).Binary logistic regression analysis showed that female and abnormal lower extremity sensation were the influencing factors of low dorsal TcPO2 of foot in elderly T2DM patients(OR=2.831,95%CI:1.517-5.285,P=0.001;OR=2.229,95%CI:1.047-4.748,P=0.038).Conclusion The incidence of low dorsal TcPO2 of foot is high in elderly T2DM patients without diabetic foot.Dorsal TcPO2 of foot is a biomarker of subclinical foot tissue perfusion in elderly T2DM patients.