糖尿病足溃疡患者愈合后复发的影响因素

Influencing factors of recurrence after healing in patients with diabetic foot ulcer

目的:分析糖尿病足溃疡(DFU)患者愈合后复发的影响因素。方法:选取2020年7月至2023年1月该院收治的178例DFU患者进行横断面研究,收集患者临床资料,检测糖化血红蛋白(HbA1c)、白蛋白(ALB)水平。随访1年,根据DFU愈合后是否复发将其纳入复发组与未复发组,采用Logistic回归分析DFU患者愈合后复发的影响因素。结果:178例DFU患者中,愈合后复发64例,复发率为35.96%(64/178);两组性别、体质量指数(BMI)、饮酒史、吸烟史、婚姻状况、合并高血压、合并冠心病、合并高脂血症、糖尿病病程、文化程度、合并糖尿病视网膜病变、合并糖尿病肾病、溃疡个数、溃疡面积、治疗方法比较,差异均无统计学意义(P>0.05);复发组年龄≥60岁、Wagner分级3~5级、溃疡部位为足底部、踝肱指数<0.9、HbA1c≥7.5%、ALB<30 g/L、溃疡部位感染程度为中重度占比均高于未复发组,差异有统计学意义(P<0.05);Logistic回归分析结果显示,年龄≥60岁、Wagner分级3~5级、溃疡部位为足底部、踝肱指数<0.9、HbA1c≥7.5%、ALB<30 g/L、溃疡部位感染程度为中重度均为DFU患者愈合后复发的危险因素(OR>1,P<0.05)。结论:年龄≥60岁、Wagner分级3~5级、溃疡部位为足底部、踝肱指数<0.9、HbA1c≥7.5%、ALB<30 g/L、溃疡部位感染程度为中重度均为DFU患者愈合后复发的危险因素。

Objective:To analyze influencing factors of recurrence after healing in patients with diabetic foot ulcer(DFU).Methods:A cross-sectional study was conducted on 178 patients with DFU admitted to the hospital from July 2020 to January 2023.The clinical data of these patients were collected.The levels of glycated hemoglobin(HbA1c)and albumin(ALB)were detected.They were followed up for 1 year.According to whether DFU recurred after healing,these patients were divided into recurrence group and non-recurrence group.Logistic regression was used to analyze the influencing factors of recurrence after healing in these patients with DFU.Results:Among the 178 DFU patients,64 cases recurred after healing,with a recurrence rate of 35.96%(64/178).There were no significant differences between the two groups in terms of gender,body mass index(BMI),drinking history,smoking history,marital status,combined hypertension,combined coronary heart disease,combined hyperlipidemia,diabetes course,education,combined diabetic retinopathy,combined diabetic nephropathy,number of ulcers,area of ulcers,and treatment methods(P>0.05).The proportions of the patients with age≥60 years old,Wagner grade 3-5,ulcer site at the foot sole,ankle brachial index<0.9,HbA1c≥7.5%,ALB<30 g/L,and moderate to severe infection at the ulcer site in the recurrence group were higher than those in the non-recurrence group,and the differences were statistically significant(P<0.05).Logistic regression analysis showed that the age≥60 years old,Wagner grade 3-5,ulcers at the foot sole,ankle brachial index<0.9,HbA1c≥7.5%,ALB<30 g/L,and moderate to severe infection at the ulcer site were risk factors for recurrence in the DFU patients after healing(OR>1,P<0.05).Conclusions:Age≥60 years old,Wagner grade 3-5,ulcers at the foot sole,ankle brachial index<0.9,HbA1c≥7.5%,ALB<30 g/L,and moderate to severe infection at the ulcer site are the risk factors for recurrence in the DFU patients after healing.