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目的探讨糖尿病足溃疡(DFU)的临床特点,分析其严重程度的危险因素。方法回顾分析90例DFU患者的临床特点,采用多因素Logistic回归分析影响DFU严重程度的危险因素。采用SPSS 19.0统计软件,计量资料以(x±s)表示,比较采用两独立样本t检验;计数资料率的比较采用x~2检验。P≤0.05为差异有统计学意义。结果 DFU患者年龄(68.03±14.85)岁,52例痊愈(57.78%),31例好转(34.44%),7例未愈(7.78%)。DFU发病有明确诱发因素26例(28.89%),无明确诱因64例(71.11%)。并发糖尿病周围神经病73例(81.11%)、糖尿病外周动脉病变72例(80.00%)、糖尿病肾病45例(50.00%)、糖尿病眼病41例(45.56%),合并吸烟31例(34.44%)、冠心病29例(32.22%)、脑梗死33例(36.67%)、高血压43例(47.78%)、高脂血症24例(26.67%);不同Wagnet分级DFU患者并发症及心血管疾病发生率比较差异均无统计学意义(均P>0.05)。DFU严重程度的危险因素有性别、农村医保、吸烟、糖尿病外周动脉病变、冠心病、脑梗塞、血脂异常、年龄、糖尿病病程(P均<0.05)。结论加强对糖尿病患者血糖的管理,及时干预各种心血管危险因素,加强对DFU早期神经病变、血管病变的筛查和高危人群的教育,预防DFU发生,改善预后,避免截肢。
Objective To investigate the clinical features of diabetic foot ulcer (DFU) and analyze the risk factors of its severity. Methods The clinical features of 90 DFU patients were retrospectively analyzed. Multivariate Logistic regression was used to analyze the risk factors affecting the severity of DFU. Using SPSS 19.0 statistical software, measurement data to (x ± s), compared with two independent samples t test; count data rate comparison using x ~ 2 test. P≤0.05 for the difference was statistically significant. Results The age of DFU patients was 68.03 ± 14.85 years old, 52 cases recovered (57.78%), 31 cases improved (34.44%) and 7 cases did not heal (7.78%). 26 cases (28.89%) had definite inducing factors of DFU, and 64 cases (71.11%) had no definite inducing factors. 73 cases (81.11%) had diabetic peripheral neuropathy, 72 cases (80.00%) had diabetic peripheral arterial disease, 45 cases (50.00%) had diabetic nephropathy, 41 cases (45.56%) had diabetic ophthalmopathy, 31 cases (34.44% 29 cases (32.22%) had heart disease, 33 cases (36.67%) had cerebral infarction, 43 cases (47.78%) had hypertension and 24 cases (26.67%) had hyperlipidemia. The complication and the incidence of cardiovascular disease There was no significant difference between the two groups (all P> 0.05). The risk factors of DFU severity were gender, rural health insurance, smoking, diabetic peripheral artery disease, coronary heart disease, cerebral infarction, dyslipidemia, age and duration of diabetes (all P <0.05). Conclusion To strengthen the management of blood glucose in diabetic patients, timely intervention of various cardiovascular risk factors, to strengthen the early DFU neuropathy, vascular disease screening and education of high-risk groups to prevent the occurrence of DFU, improve prognosis and avoid amputation.