2型糖尿病患者合并手部病变的相关因素分析

Correlation analysis of diabetic hand in patients with type 2 diabetes mellitus

目的探讨T2DM患者合并手部病变(简称糖尿病手)的相关因素,为降低糖尿病手的风险提供理论依据。方法选取2019年2月至2020年2月于重庆医科大学附属第一医院内分泌内科住院部收治的530例T2DM患者,按是否有手部病变分为手部病变组(DH,n=136)和单纯T2DM组(T2DM,n=394),比较两组一般资料及生化指标,多因素Logistic回归分析手部病变的影响因素。结果 DH组年龄、DM病程、DR、糖尿病周围神经病变(DPN)、DKD、颈动脉斑块及下肢动脉斑块阳性率、白细胞计数、中性粒细胞-淋巴细胞比率(NLR)、血清尿素、UAlb水平均高于T2DM组(P<0.05),红细胞计数、血红蛋白、TG、eGFR低于T2DM组(P<0.05)。多因素Logistic回归分析发现,DM病程(OR 1.041,95%CI 1.004,1.066)、DPN(OR 1.899,95%CI 1.007,3.580)和NLR(OR 1.035,95%CI 1.008,1.063)是糖尿病手的独立危险因素。结论 T2DM患者DM病程越长,合并DPN及NLR越高,出现糖尿病手的风险越高。

Objective To explore the related factors of hand lesions in patients with type 2 diabetes mellitus(T2DM), and provide the evidence of reducing diabetic hand.Methods A total of 530 T2DM inpatients from February 2019 to February 2020 were divided into hand lesion group(DH,n=136) and non-hand lesion group(T2DM,n=394).The clinical data and laboratory data were collected and analyzed.Results Single variable analysis showed that age,duration of diabetes,diabetic retinopathy(DR),diabetic peripheral neuropathy(DPN),diabetic kidney disease(DKD),carotid plaques and lower extremity artery plaque positive rate,white blood cell count(WBC),neutrophil-lymphocyte ratio(NLR),serum urea(Urea),urine trace albumin(UAlb) levels were significantly increased in DH group(P<0.05) when compared with non-hand lesion group.Red blood cells count(RBC),hemoglobin(Hb),triglyceride(TG),and estimated glomerular filtration rate(eGFR) in DH group were markedly lower than those in non-hand lesion group(P<0.05).Multivariate Logistic regression analysis showed that course of diabetes(OR 1.041,95% CI1.004,1.066),DPN(OR 1.899,95% CI 1.007,3.580) and NLR(OR 1.035,95% CI 1.008,1.063)were independent risk factors of amputation in diabetic hand patients.Conclusion In T2DM patients,a longer course of DM,the presence of DPN,and a higher NLR ratio increase the risk of diabetic hands.