Malgrange D, Richard J L, Leymarie F
Clinique Médicale B, Hôpital Robert Debré, CHU, Reims, France.
Diabetes Metab. 2003 Jun;29(3):261-8. doi: 10.1016/s1262-3636(07)70035-6.
To determine the prevalence of risk factors for diabetic foot ulceration in diabetic patients free of active pedal ulceration in a hospital setting.
In sixteen French diabetology centres, a survey was conducted on a given day in all diabetic people attending the units, both as in- or out-patients.
664 patients were evaluated: 105 had an active foot ulcer and were excluded from the analysis as were four other patients due to lack of reliable data. From the 555 assessable patients, 40 (7.2%) had a history of foot ulcer or lower-limb amputation. Sensory neuropathy with loss of protective sensation, as measured by the 5.07 (10 g) Semmes-Weinstein monofilament testing, was present in 27.1% of patients, whereas 17% had a peripheral arterial disease mainly based on the clinical examination. On addition, foot deformities were found in 117 patients (21.1%). According to the classification system of the International Working Group on the Diabetic Foot, 72.8% of patients were at low-risk for pedal ulceration (grade 0) and 17,5% were in the higher-risk groups (grade 2 & 3). If patients with isolated peripheral arterial disease were considered as a separate risk group (as was those with isolated neuropathy), percentage of low-risk patients decreased to 65.6%. There was a clear trend between the increasing severity of the staging and age, duration of diabetes, prevalence of nephropathy and retinopathy.
Prevalence of risk factors for foot ulceration is rather high in a hospital-based diabetic population, emphasising the need for implementing screening and preventive strategies to decrease the burden of diabetic foot problems and to improve the quality of life for people with diabetes.
确定在医院环境中无足部活动性溃疡的糖尿病患者发生糖尿病足溃疡的危险因素的患病率。
在16个法国糖尿病中心，于某一天对所有在各科室就诊的糖尿病患者（包括门诊和住院患者）进行了一项调查。
共评估了664例患者：105例有足部活动性溃疡，因缺乏可靠数据，另有4例患者被排除在分析之外。在555例可评估患者中，40例（7.2%）有足部溃疡或下肢截肢病史。通过5.07（10克）Semmes-Weinstein单丝测试测量，27.1%的患者存在保护性感觉丧失的感觉神经病变，而17%的患者主要根据临床检查患有外周动脉疾病。此外，在117例患者（21.1%）中发现足部畸形。根据糖尿病足国际工作组的分类系统，72.8%的患者足部溃疡风险较低（0级），17.5%的患者属于高风险组（2级和3级）。如果将单纯外周动脉疾病患者视为一个单独的风险组（与单纯神经病变患者一样），低风险患者的比例降至65.6%。分期严重程度增加与年龄、糖尿病病程、肾病和视网膜病变患病率之间存在明显趋势。
在以医院为基础的糖尿病患者人群中，足部溃疡危险因素的患病率相当高，这强调了实施筛查和预防策略以减轻糖尿病足问题负担并改善糖尿病患者生活质量的必要性。
