Walters D P, Gatling W, Mullee M A, Hill R D
Department of Diabetic Medicine, Poole General Hospital, Dorset, UK.
Diabet Med. 1992 May;9(4):354-8. doi: 10.1111/j.1464-5491.1992.tb01796.x.
A surveillance programme was undertaken to identify all diabetic patients with foot disease in a defined population with the same age and sex structure as that of the UK. Of 1150 diabetic patients identified, 1077 were reviewed either at home or in hospital. The presence of foot deformity, amputation, and foot ulceration was determined. The site, depth, and duration of ulcers were recorded and any previous ulceration noted. All feet with ulcers were X-rayed. A non-diabetic comparison group of 480 age- and sex-matched individuals were also examined by the same observer. The prevalence of past or present foot ulceration was 7.4 (95% CI 5.8-9.0)% in diabetic patients and 2.5 (95% CI 1.1-3.9)% in the non-diabetic group, yielding an odds ratio of 2.94 (95% CI 1.58-5.48) (p less than 0.001) for the occurrence of foot ulceration in diabetic patients. Of the ulcers found on examination, 39.4% were neuropathic, 24.2% were vascular, and 36.4% were mixed. Multiple logistic regression analysis of selected variables revealed that duration of diabetes, absent light touch, impaired pain perception, absent dorsalis pedis pulse, and the presence of any retinopathy were significant predictors of the presence of foot ulcers. The prevalence of amputation in diabetic patients was 1.3 (95% CI 0.6-2.0)%, but there were no amputations in the non-diabetic group.
开展了一项监测计划，以识别特定人群中所有患有足部疾病的糖尿病患者，该人群具有与英国相同的年龄和性别结构。在识别出的1150名糖尿病患者中，有1077名患者在家中或医院接受了检查。确定是否存在足部畸形、截肢和足部溃疡。记录溃疡的部位、深度和持续时间，并注明既往是否有溃疡。所有有溃疡的足部均进行了X光检查。另一名观察者还对480名年龄和性别匹配的非糖尿病对照组个体进行了检查。糖尿病患者过去或现在足部溃疡的患病率为7.4（95%可信区间5.8 - 9.0）%，非糖尿病组为2.5（95%可信区间1.1 - 3.9）%，糖尿病患者发生足部溃疡的比值比为2.94（95%可信区间1.58 - 5.48）（p小于0.001）。在检查中发现的溃疡，39.4%为神经病变性，24.2%为血管性，36.4%为混合型。对选定变量进行的多因素逻辑回归分析显示，糖尿病病程、轻触觉缺失、疼痛感知受损、足背动脉搏动消失以及任何视网膜病变的存在是足部溃疡存在的重要预测因素。糖尿病患者截肢的患病率为1.3（95%可信区间0.6 - 2.0）%，但非糖尿病组无截肢病例。
