北京市多中心筛查糖尿病高危足及其危险因素分析

A multi-centered study in diabetic at-risk foot screening and risk factor analysis in Beijing

目的探讨糖尿病高危足(DFR)的分级现状并分析其危险因素。方法采用方便取样法对北京市11家医疗机构的3758例糖尿病患者行足部筛查,其中男2024例,女1734例,平均年龄(62.97±11.40)岁,平均糖尿病病程(11.33±7.91)年,对足部病变和DFR 0+~3级的危险因素进行分析。结果DFR 1~3级共1770例(47.1%),分别为1级489例(13.0%)、2级1227例(32.7%)、3级54例(1.4%)。Logistic回归分析显示,性别(OR 1.179,95%CI 1.029~1.350)、糖尿病病程(OR 1.026,95%CI 1.017~1.035)、高脂血症(OR 1.580,95%CI 1.377~1.814)和慢性肾脏病(OR 2.231,95%CI 1.534~3.245)是糖尿病患者发生足部病变的危险因素;有序Logistic回归分析显示,性别(OR 1.221,95%CI 1.020~1.462)、糖尿病病程(OR 1.024,95%CI 1.016~1.033)、高脂血症(OR 1.532,95%CI 1.342~1.747)和慢性肾脏病(OR 1.879,95%CI 1.354~2.608)是DFR进展的危险因素。结论满足粗筛指标的糖尿病患者47.1%发生足部病变。性别、糖尿病病程、高脂血症和慢性肾脏病是糖尿病患者发生足部病变和DFR的危险因素。

Objective To investigate the categories and risk factors for at-risk foot in diabetes.Methods A total of 3758 patients with diabetes were recruited in this study from 11 hospitals in Beijing by convenient sampling method.Among them,2024 were male and 1734 were female.The average age was 62.97±11.40 years old,and the average duration of diabetes was(11.33±7.91)years.Risk for foot lesions and at-risk foot(Grade 0+to 3)was evaluated.Results There were 47.1%(1770)cases of Grade 1~3 at-risk foot,among which 13.0%(489)of Grade 1,32.7%(1227)of Grade 2,1.4%(54)of Grade 3.Logistic regression analysis suggested that risk factors for foot lesions included gender(OR 1.179,95%CI 1.029~1.350),duration of diabetes(OR 1.026,95%CI 1.017~1.035),hyperlipidemia(OR 1.580,95%CI 1.377~1.814)and chronic kidney diseases(OR 2.231,95%CI 1.534~3.245).Ordinal logistic regression analysis suggested that risk factors for at-risk foot included gender(OR 1.221,95%CI1.020~1.462),duration of diabetes(OR 1.024,95%CI 1.016~1.033),hyperlipidemia(OR 1.532,95%CI1.342~1.747)and chronic kidney diseases(OR 1.879,95%CI 1.354~2.608).Conclusion There were 47.1%with foot lesions in patients fulfilling primary screening test criteria.Gender,duration of diabetes,hyperlipidemia and chronic kidney disease were risk factors for foot lesions and at-risk foot progression in patients with diabetes.