老年糖尿病足患者营养情况与病情严重程度的相关性分析

Correlation between Nutritional Status and Disease Severity in Elderly Patients with Diabetes Foot

【目的】探讨老年糖尿病足(DF)患者营养情况与病情严重程度的相关性。【方法】选取2019年9月至2020年9月在西安大兴医院诊治的102例老年DF患者(观察组),并根据Wagner诊断分级标准分为Ⅰ~Ⅱ级(n=38)、Ⅲ~Ⅴ级(n=64)。另选取同期在西安大兴医院诊治的102例老年糖尿病患者(对照组)。比较两组患者入院时的血脂指标[三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)]和营养指标[血清总蛋白(TP)、前白蛋白(PA)、血红蛋白(Hb)、白蛋白(ALB)];采用受试者工作特征(ROC)曲线分析TC、PA、Hb、ALB水平对老年DF的预测价值,采用Spearman系数分析血清TC、PA、Hb、ALB水平与老年DF患者病情严重程度的相关性。【结果】两组患者TG、HDL-C、LDL-C、TP水平比较,差异无统计学意义(P>0.05),观察组TC、PA、Hb、ALB水平均显著低于对照组,差异有统计学意义(P<0.05)。经ROC曲线分析显示:TC≤4.510 mmol/L、PA≤221.004 mg/L、Hb≤131.640 g/L、ALB≤36.693 g/L是预测老年DF的最佳截断值,TC、PA、Hb、ALB预测老年DF的曲线下面积分别为0.641、0.802、0.936、0.781(P<0.05)。Wagner分级Ⅰ~Ⅱ级患者与Ⅲ~Ⅴ级患者TG、HDL-C、LDL-C、TP水平比较,差异无统计学意义(P>0.05),Ⅲ~Ⅴ级患者TC、PA、Hb、ALB水平均显著低于Ⅰ~Ⅱ级患者,差异有统计学意义(P<0.05)。老年DF患者血清TC、PA、Hb、ALB水平与患者病情严重程度呈负相关(P<0.05)。【结论】老年糖尿病患者的TC、PA、Hb、ALB水平与患者并发DF密切相关,临床需对老年糖尿病患者TC、PA、Hb、ALB水平予以监测,并及时采取个性化干预措施。

【Objective】To explore the correlation between nutritional status and disease severity in elderly patients with diabetes foot.【Methods】A total of 102 elderly patients with diabetic foot(DF)in our hospital from September 2019 to September 2020 were selected as the observation group;And patients were divided into gradeⅠ~Ⅱ(n=38)and gradeⅢ~Ⅴ(n=64)according to Wagner diagnostic grading standard of the disease severity.A total of 102 elderly patients with diabetes treated in our hospital during the same period were selected as the control group.Blood lipid indexes[triglyceride(TG),total cholesterol(TC),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C)]and nutritional indexes[serum total protein(TP),prealbumin(PA),hemoglobin(Hb),albumin(ALB)]were detected at admission.The predictive value of TC,PA,Hb and ALB levels on DF was analyzed by ROC.The relationship of disease severity with serum TC,PA,Hb and ALB levels was analyzed by Spearman coefficient.【Results】There were no significant differences in TG,HDL-C,LDL-C and TP between the two groups(P>0.05).The levels of TC,PA,Hb and ALB in the observation group were significantly lower than those in the control group.The differences were statistically significant(P<0.05).According to the ROC curve analysis,TC≤4.510 mmol/L,PA≤221.004 mg/L,Hb≤131.640 g/L and ALB≤36.693 g/L were the best cut-off values for predicting DF.The areas under the curve of TC,PA,Hb and ALB for predicting DF were 0.641,0.802,0.936 and 0.781,respectively(P<0.05).There were no significant differences in TG,HDL-C,LDL-C and TP between Wagner gradeⅠ~Ⅱpatients andⅢ~Ⅴpatients(P>0.05).The levels of TC,PA,Hb and ALB inⅢ~Ⅴpatients were significantly lower than those inⅠ~Ⅱpatients;And the differences were statistically significant(P<0.05).The serum levels of TC,PA,Hb and ALB in DF patients were negatively correlated with the severity of the disease(all P<0.05).【Conclusion】The nutritional status of diabetic patients is closely related to the occurrence of DF.TC,PA,Hb and ALB of diabetic patients should be monitored and personalized intervention measures should be taken in time.