糖尿病足患者下肢动脉造影的特征性分析及其与Wagner分级的影响因素研究

Characteristics of lower extremity arteriography in diabetic foot patients and its correlation with Wagner classification

目的探讨糖尿病足(diabetic foot,DF)患者下肢动脉造影的特征及其与Wagner分级的关系,明确DF患者下肢动脉病变的特点并拓展Wagner分级临床应用。方法纳入2016年1月至2022年10月住院的210例糖尿病患者,分为非糖尿病足组(NDF组,46例)和糖尿病足组(DF组,164例)。收集其一般临床资料、实验室检查结果及下肢动脉造影数据。结果与NDF组相比,DF组患者年龄较大,多合并高血脂、冠心病,糖尿病肾病患病率较高,糖化血红蛋白、甘油三酯、低密度脂蛋白水平较高;DF组患者下肢血管狭窄率及闭塞率较高(P<0.05),膝下动脉的闭塞率(32.52%)明显高于膝上动脉的闭塞率(3.93%),膝下动脉的总累积率(54.27%)明显高于膝上动脉总累计率(40.85%)。与低级别Wagner分级组比较,高级别Wagner分级组膝下动脉的闭塞率较高(P<0.05)。结论DF患者下肢血管病变以膝下动脉闭塞为主,Wagner分级对DF患者下肢血管闭塞有一定的预测能力。

Objective To explore the characteristics of lower extremity arteriography in patients with diabetic foot(DF)and its relationship with the Wagner classification.Furthermore,this study aims to elucidate the distinctive features of lower extremity arterial diseases in DF patients and expand the clinical application of the Wagner classification.Methods A total of 210 hospitalized diabetic patients were enrolled between January 2016 and October 2022 and divided into the non-DF group(NDF,46 cases)and the DF group(DF,164 cases).The clinical data,laboratory examination results,and lower extremity arteriography data were collected.Results Compared to the NDF group,patients in the DF group were older,had higher rates of comorbidities such as hyperlipidemia,coronary heart disease,and diabetic nephropathy,and displayed higher levels of glycated hemoglobin,triglycerides,and low-density lipoprotein.Moreover,the DF group exhibited higher rates of stenosis and occlusion in the lower extremity vessels(P<0.05).Notably,the occlusion rate of the inferior genicular artery(32.52%)was significantly higher than that of the superior genicular arteries(3.93%),and the total cumulative rate of the inferior genicular arteries(54.27%)was markedly higher than that of the superior genicular arteries(40.85%).When comparing the high-grade Wagner classification group with the low-grade group,the former had a higher occlusion rate in the inferior genicular arteries(P<0.05).Conclusion The lower extremity vascular diseases in DF patients are mainly inferior genicular artery occlusion.The Wagner may serve as a predictive factor for lower extremity vascular occlusion.