影响糖尿病患者足踝溃疡预后的因素分析

Analysis of Factors Affecting the Prognosis of Ankle Ulcers in Diabetic Patients

目的探讨影响糖尿病患者足踝溃疡预后的因素分析。方法选择2018年4月—2020年6月该院收治的糖尿病患者足踝溃疡60例,根据患者足踝溃疡是否痊愈,60例患者分成痊愈组和未痊愈组,比较两组患者一般资料(性别、年龄、BMI指数、病程、溃疡病程、血压、吸烟史、饮酒史等),溃疡数目、大小、严重程度,空腹血糖、糖化血红蛋白、血脂水平,踝肱指数,神经病变,足背动脉血流速度等对预后的影响。结果 60例患者中治愈48例,未治愈12例。以是否发生足部溃疡为因变量,将单因素分析中有统计学意义的各项因素作为自变量,经Logistic回归分析结果显示:男性、年龄和BMI指数大,糖尿病病程和溃疡病程长,有吸烟史、饮酒史、高血压,空腹血糖、糖化血红蛋白、总胆固醇、三酰甘油、低密度脂蛋白的水平高和高密度脂蛋白的水平低,溃疡数目多、溃疡面积大、Wagner分级高、感染程度严重,踝肱指数高,存在神经病变,足背动脉血流速度低均是发生足部溃疡的独立危险因素。结论根据患者性别、年龄和BMI指数等自身情况,针对其血糖、血脂、足踝溃疡等影响糖尿病足踝溃疡预后的因素积极干预治疗,可以提改善患者预后。

Objective To explore the prognostic factors of ankle ulcers in diabetic patients. Methods From April 2018 to June 2020, 60 cases of foot and ankle ulcers in diabetic patients were selected. According to whether the patient’s ankle ulcer is healed, 60 patients were divided into healed group and non-healed group. The effects of general information(sex,age, BMI index, course of disease, course of ulcer, blood pressure, smoking history, drinking history, etc.), number, size,severity of ulcers, fasting blood glucose, glycosylated hemoglobin, blood lipid level, ankle-brachial index, neuropathy, dorsal artery blood flow velocity, etc. on the prognosis of the two groups were compared. Results Of the 60 patients, 48 were cured and 12 were uncured. Taking the occurrence of foot ulcers as the dependent variable, the statistically significant factors in the univariate analysis were used as independent variables. The Logistic regression analysis showed that the sex, male, age and large BMI index, and the course of diabetes and ulcer was long, history of smoking, drinking and high blood pressure,high levels of fasting blood glucose, glycosylated hemoglobin, total cholesterol, triacylglycerol, low-density lipoprotein and low levels of high-density lipoprotein, high number of ulcers, large ulcer area, high Wagner grade, severe infection severity,high ankle-brachial index, neuropathy, and low dorsal artery blood flow velocity were independent risk factors for foot ulcers. Conclusion According to the patient’s own conditions such as gender, age and BMI index, active intervention and treatment for factors affecting the prognosis of diabetic foot and ankle ulcers such as blood sugar, blood lipids, and ankle ulcers can improve the prognosis of patients.