Lipsky Benjamin A
Diabetes Metab Res Rev. 2004 May-Jun;20 Suppl 1:S68-77. doi: 10.1002/dmrr.453.
In persons with diabetes, foot infection, that is, invasion and multiplication of microorganisms in tissues accompanied by tissue destruction or a host inflammatory response, usually begins with skin trauma or ulceration 1. While most foot infections remain superficial, they can spread to subcutaneous tissues, including muscle, joints, and bone. Many diabetic foot ulcers eventuate in an amputation; infection plays a role in approximately 60% of cases 2-4. Neuropathy is the main factor leading to skin breaks, while arterial perfusion largely affects infection outcome. Among the factors predisposing diabetic patients to foot infections are ill-defined immunological perturbations 56; foot anatomy may foster proximal spread of infection and ischemic necrosis 78.
在糖尿病患者中,足部感染,即微生物在组织中侵入并繁殖,同时伴有组织破坏或宿主炎症反应,通常始于皮肤创伤或溃疡[1]。虽然大多数足部感染仍局限于浅表,但可蔓延至皮下组织,包括肌肉、关节和骨骼。许多糖尿病足溃疡最终导致截肢;感染在约60%的病例中起作用[2-4]。神经病变是导致皮肤破损的主要因素,而动脉灌注在很大程度上影响感染的结局。使糖尿病患者易发生足部感染的因素包括尚不明确的免疫紊乱[5,6];足部解剖结构可能促使感染近端蔓延和缺血性坏死[7,8]。