Diabetic Foot Disease Center, Shanghai Yuanyang Hospital, Shanghai, China.
J Diabetes. 2013 Dec;5(4):429-38. doi: 10.1111/1753-0407.12062. Epub 2013 Jun 14.
In the present study we: (i) evaluated the incidence of heart failure (HF) in patients with diabetic foot ulcer (DFU); and (ii) investigated the relationship between the clinical characteristics in these patients and prognosis.
The clinical characteristics of 330 consecutive Chinese patients (137 men, 193 women) hospitalized for DFU were collected and assessed to determine the effects of HF on DFU. All patients were followed for 3 months and rates of healing, the development of new ulcers, amputations, and mortality were calculated at the end of the follow-up period.
Heart failure was present in 64.3% of patients with DFU, with the prevalence of HF increasing with Wagner grade from Wagner 1 through to Wagner 5 (42.4%, 59.1%, 64.7%, 73.3%, and 87.0%, respectively), higher than the 33.6% prevalence in diabetic patients without DFU (Wagner 0). The presence of HF conferred a greater increased relative risk of a worse prognosis. The 3-month healing rates of DFU in patients with and without HF were 60.3% and 75.7%, respectively. Recurrence (13.2% vs 7.5%) and amputations (28.6% vs 20.0%) were more frequent in patients with than without HF (P < 0.05). All-cause mortality was recorded for 14 of 126 patients with HF compared with three of 70 patients without HF (11.1% vs 4.3%, respectively; P < 0.05).
The prevalence of HF is high in Chinese inpatients with DFU, with the presence of HF indicating a worse prognosis for these patients.
本研究：（i）评估糖尿病足溃疡（DFU）患者心力衰竭（HF）的发生率；（ii）探讨这些患者的临床特征与预后之间的关系。
收集了 330 例连续住院的中国 DFU 患者（男 137 例，女 193 例）的临床特征，并进行评估，以确定 HF 对 DFU 的影响。所有患者均随访 3 个月，在随访结束时计算愈合率、新发溃疡、截肢和死亡率。
64.3%的 DFU 患者存在 HF，HF 的患病率随 Wagner 分级从 Wagner 1 级增加至 Wagner 5 级（分别为 42.4%、59.1%、64.7%、73.3%和 87.0%），高于无 DFU 的糖尿病患者的 33.6%（Wagner 0 级）。HF 的存在使预后更差的相对风险增加。有和无 HF 的 DFU 患者的 3 个月愈合率分别为 60.3%和 75.7%。HF 患者的复发（13.2%比 7.5%）和截肢（28.6%比 20.0%）更为常见（P<0.05）。HF 患者中有 14 例（11.1%）和无 HF 患者中有 3 例（4.3%）发生全因死亡（P<0.05）。
中国住院 DFU 患者 HF 的患病率较高，HF 的存在表明这些患者的预后较差。
