糖尿病足溃疡愈合后复发的危险因素分析

Analysis of risk factors for recurrence of diabetes foot ulcer after healing

目的 探讨糖尿病足溃疡(DFU)愈合后2年随访期间复发的危险因素。方法 收集2019年3月至2021年7月新疆医科大学第一附属医院收治的124例DFU患者的临床资料,按照愈合后2年随访期间是否复发将患者分为复发组(n=40)和对照组(n=84)。采用多因素Logistic回归模型分析DFU愈合后2年随访期间复发的危险因素。结果 复发组患者的年龄、糖尿病病程、治疗前糖化血红蛋白水平、合并股腘动脉闭塞的比例均高于对照组患者,但随访期间长期服用阿司匹林的比例低于对照组患者,差异均有统计学意义(P﹤0.05)。多因素分析结果显示,年龄﹥65岁、糖尿病病程﹥10年、治疗前糖化血红蛋白﹥7.0%、合并股腘动脉闭塞以及随访期间未长期服用阿司匹林均是DFU愈合后2年随访期间复发的独立危险因素(P﹤0.05)。两组患者危险因素的分布情况比较,差异有统计学意义(P=0.008)。结论 年龄、糖尿病病程、治疗前糖化血红蛋白水平、合并股腘动脉闭塞以及愈合后服用阿司匹林情况均与DFU愈合后复发密切相关,临床中应密切关注。

Objective To analyze the risk factors of recurrence of diabetes foot ulcer(DFU)during 2-year follow-up after healing.Method Clinical data of 124 DFU patients admitted in the First Affiliated Hospital of Xinjiang Medical University from March 2019 to July 2021 were collected,and all patients were divided into the recurrence group(n=40)and control group(n=84)based on recurrence during the 2-year follow-up after healing.The risk factors for recurrence of DFU during 2-year follow-up after healing were analyzed by multivariate Logistic regression model.Result The age,course of diabetes,the level of glycosylated hemoglobin before treatment,and the ratio of patients with femoral popliteal artery occlusion in the recurrence group were significantly higher than those in the control group,but the proportion of long-term aspirin use during follow-up was lower than that in the control group,and the differences were statistically significant(P<0.05).Multivariate Logistic regression model showed that age>65 years old,course of diabetes>10 years,level of glycosylated hemoglobin before treatment>7.0%,combined femoral popliteal artery occlusion and no long-term use of aspirin during follow-up were independent risk factors for recurrence during the 2-year follow-up period after DFU healing(P<0.05).There was a statistically significant difference in the distribution of risk factors between the two groups(P=0.008).Conclusion Age,course of diabetes,the level of glycosylated hemoglobin before treatment,combined femoral popliteal artery occlusion and aspirin use after healing are closely related to the recurrence of DFU after healing,which should be paid close attention in clinical practice.