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评估糖尿病足溃疡的危险因素及其对疾病结局的影响。

Assessment of risk factors in diabetic foot ulceration and their impact on the outcome of the disease.

机构信息

Department of surgery, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.

出版信息

Prim Care Diabetes. 2009 Nov;3(4):219-24. doi: 10.1016/j.pcd.2009.08.009. Epub 2009 Sep 23.

Abstract

AIMS

The current study aims to identify risk factors for diabetic foot ulcer and their impact on the outcome of the disease.

METHODS

Three hundred diabetic patients were enrolled in the study. One hundred eighty subjects with diabetic foot ulcer and 120 diabetic controls without foot lesions. All expected risk factors were studied in all patients and after a follow up period, patients with diabetic foot ulcer were classified into group A (patients with healed ulcers) and group B (patients with persistent ulcer or ended by amputation). The risk factors were reanalyzed in both groups to find out their impact on the outcome of the disease.

RESULTS

The following variables were significant factors for foot ulceration: Male gender (P=0.009), previous foot ulcer (P=0.003), peripheral vascular disease (P=0.004), and peripheral neuropathy (P=0.006). Also lack of frequent foot self-examination was independently related to foot ulcer risk. The outcome was related to longer diabetes duration (P=0.004), poor glycaemic control (P=0.006) and anaemia (P=0.003) and presence of infection (P<0.001).

CONCLUSIONS

Peripheral vascular disease and peripheral neuropathy together with lack of foot self-examination, poor glycaemic control and anaemia are main significant risk factors for diabetic foot ulceration.

摘要

目的

本研究旨在确定糖尿病足溃疡的危险因素及其对疾病结局的影响。

方法

纳入 300 例糖尿病患者。180 例为糖尿病足溃疡患者,120 例为无足部病变的糖尿病对照患者。所有预期的危险因素均在所有患者中进行研究,在随访期结束后,将糖尿病足溃疡患者分为 A 组(溃疡愈合患者)和 B 组(溃疡持续存在或因截肢而结束的患者)。在这两组中重新分析危险因素,以发现它们对疾病结局的影响。

结果

以下变量是足部溃疡的显著因素:男性(P=0.009)、既往足部溃疡(P=0.003)、外周血管疾病(P=0.004)和周围神经病变(P=0.006)。此外,缺乏频繁的足部自我检查与足部溃疡风险独立相关。结局与糖尿病病程较长(P=0.004)、血糖控制不佳(P=0.006)和贫血(P=0.003)以及感染有关(P<0.001)。

结论

外周血管疾病和周围神经病变以及缺乏足部自我检查、血糖控制不佳和贫血是糖尿病足溃疡的主要显著危险因素。

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