2型糖尿病足溃疡患者足部病变程度与血尿酸水平的关系

Association between the severity of diabetic foot ulcer and uric acid level in type 2 diabetic patients

目的探讨住院2型糖尿病患者足部溃疡的严重程度(Wagner1-5级)与血尿酸之间的关系。方法选取2017年1月~2018年5月在我院内分泌科住院的134例2型糖尿病足溃疡患者,根据血尿酸水平分为高尿酸组及尿酸正常组,比较两组患者一般资料及临床指标的差异,分析2型糖尿病足溃疡患者合并高尿酸血症的影响因素。同时将Wagner1级(W1)、2级(W2)、3级(W3)各分为一组,4级和5级为一组(W4),分析4组患者的临床特征及血尿酸水平的情况,了解4组患者足部病变严重程度与血尿酸水平的相关性。结果与NUA组相比,HUA组患者Wagner分级均升高(P<0.05),同时HUA组吸烟率增加,糖尿病病程、WBC、血肌酐均升高,差异有统计学意义(P<0.05),但HUA组较NUA组糖化血红蛋白降低(P<0.05)。二元logistic回归分析结果显示,糖尿足合并HUA组中,Wagner分级是血尿酸升高的独立危险因素(P<0.05)。W1-W4组间患者中吸烟、糖尿病病程、TC、LDL、WBC、RBC、Hb、Alb、Ca、UA均有统计学差异(P<0.05),且随着足部病变程度的加重,患者血尿酸水平逐渐升高。Wagner分级与糖尿病病程、WBC及血尿酸呈正相关(P<0.05),与RBC、Hb、Alb、Tc、LDL、Ca呈负相关(P<0.05)。校正多因素Logistic回归分析后,与W1组相比,W2、W3、W4组与血尿酸的OR值逐渐增加(P<0.05)。结论2型糖尿病足溃疡患者足部病变程度与血尿酸之间具有相关性,糖尿病足溃疡合并高尿酸血症的患者足溃疡更严重。同时随着足部病变程度的加重,患者血尿酸水平逐渐升高。

Objective To explore the relationship between the severity of diabetic foot ulcer(Wagner grade:1-5)and uric acid level in patients with type 2 diabetes.Methods A retrospective study was conducted on 134 hospitalized Type 2 diabetic patients with diabetic foot ulcer(DFU)attended our hospital from January 2017 to May 2018.According to serum acid levels,the patients were divided into high uric acid(HUA)group and normal uric acid(NUA)group.The differences in general data and clinical indicators between the two groups and logistic regression were used to analyze the influencing factors of hyperuricemia in DFU patients.The DFU patients with Wagner1(W1),2(W2)and 3(W3)were divided into a group,Wagner 4 and 5 into another group(W4).We analyzed the clinical characteristics and uric acid levels between the four groups,and to investigate the correlation between the severity of foot ulcer lesions and uric acid levels of the 4 groups.Results Compared with the NUA group,the Wagner grade of the patients in the HUA group was higher(P<0.05),while the smoking rate,the course of diabetes,WBC and creatinine of the patients in the HUA group were higher(P<0.05),but the glycosylated hemoglobin in the HUA group was lower(P<0.05).The results of binary logistic regression analysis showed that Wagner grade was an independent risk factor for the increase of serum uric acid in diabetic foot combined with Hua Group(P<0.05).There were statistically significant differences in smoking,course of diabetes,TC,LDL,WBC,RBC,Hb,ALB,CA,UA among W1-W4 groups.P.Wagner's grade was positively correlated with the course of diabetes,WBC and serum uric acid(P<0.05),and negatively correlated with RBC,Hb,ALB,TC,LDL and Ca(P<0.05).After adjustment of multivariate logistic regression analysis,the or value of W2,W3,W4 and blood uric acid increased gradually compared with W1 group(P<0.05).Conclusion There was a relationship between the degree of DFU and uric acid in type 2 diabetes,and the foot ulcer was more serious in patients with diabetic foot ulcer combined with hyperuricemia.Meanwhile,the higher the Wagner classification grade for DFU,the higher the serum uric acid is.