Wang Aiping, Sun Xinjuan, Wang Wei, Jiang Kechun
Department of Endocrinology, 454 Hospital of PLA, Nanjing, China.
Diabet Foot Ankle. 2014 Mar 11;5. doi: 10.3402/dfa.v5.22936. eCollection 2014.
Few studies have identified factors as predictors of clinical prognosis of patients with diabetic foot ulcers (DFUs), especially of Chinese patients. In this study, we assessed the prognostic factors of Chinese patients with DFUs.
This was a retrospective study (January 2009-January 2011) of 194 DFUs conducted in an inpatient population at PLA 454 Hospital in Nanjing, China, to determine the prognostic influential factors of DFUs in Chinese patients. All of the studied patients were grouped into an amputation group, a non-healing group, and a cured group, according to the clinical prognosis. Patient parameters, including gender, age, smoking habits, education level, family history of diabetes mellitus, medical history, duration of foot lesions and complications, ankle-brachial index (ABI), transcutaneous oxygen pressure (TcPO2), urinary albumin/creatinine ratio (Alb/Cr), fundus oculi, electrocardiogram, DFU characteristics, bacterial nature, and neuropathy, were cross-studied among the three groups.
Compared with the other two groups, the amputation group showed a higher number of males, older in age, lower ABI and TcPO2 levels, higher Wagner wound grading and size, and significantly higher urinary Alb/Cr ratio, blood urea nitrogen, serum creatinine, white blood cell count, and erythrocyte sedimentation rate. Compared to the cured group (162 patients), more patients with an older age, smoking, family history of diabetes mellitus, medical history of foot ulcerations, lower ABI and TcPO2 levels, higher urine Alb/Cr ratio, and serum creatinine were found in the non-healing group. Regression analysis was used to study the correlation between various factors and clinical prognosis, and the results were as follows: age, Wagner wound classification, and heel ulcerations were negatively correlated to the DFU prognosis, whereas the female population, ABI, and TcPO2 were positively correlated with DFU prognosis.
In this retrospective study, we conclude that the DFU prognosis may be related to age, gender, wound location (heel), Wagner wound classification, ABI, and TcPO2 levels in the Chinese population.
很少有研究确定糖尿病足溃疡（DFU）患者临床预后的预测因素，尤其是中国患者。在本研究中，我们评估了中国DFU患者的预后因素。
这是一项回顾性研究（2009年1月至2011年1月），在中国南京解放军第454医院的住院患者中对194例DFU进行研究，以确定中国患者DFU的预后影响因素。根据临床预后，将所有研究患者分为截肢组、未愈合组和治愈组。对患者参数进行交叉研究，这些参数包括性别、年龄、吸烟习惯、教育水平、糖尿病家族史、病史、足部病变和并发症持续时间、踝肱指数（ABI）、经皮氧分压（TcPO2）、尿白蛋白/肌酐比值（Alb/Cr）、眼底、心电图、DFU特征、细菌性质和神经病变，在三组之间进行交叉研究。
与其他两组相比，截肢组男性人数较多、年龄较大、ABI和TcPO2水平较低、Wagner伤口分级和大小较高，尿Alb/Cr比值、血尿素氮、血清肌酐、白细胞计数和红细胞沉降率显著更高。与治愈组（162例患者）相比，未愈合组中年龄较大、吸烟、有糖尿病家族史、有足部溃疡病史、ABI和TcPO2水平较低、尿Alb/Cr比值和血清肌酐较高的患者更多。采用回归分析研究各种因素与临床预后之间的相关性，结果如下：年龄、Wagner伤口分类和足跟溃疡与DFU预后呈负相关，而女性人群、ABI和TcPO2与DFU预后呈正相关。
在这项回顾性研究中，我们得出结论，中国人群中DFU的预后可能与年龄、性别、伤口部位（足跟）、Wagner伤口分类、ABI和TcPO2水平有关。
