Zhang Yujie, Liu Hui, Yang Yadi, Feng Chaochen, Cui Liwei
School of Humanities and Management, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China.
Department of Quality Management, Jining N0.1 People's Hospital, Jining, Shandong, China.
Front Endocrinol (Lausanne). 2024 Aug 30;15:1405301. doi: 10.3389/fendo.2024.1405301. eCollection 2024.
This study aimed to comprehensively analyze the incidence of amputation in Chinese patients with diabetic foot ulcers (DFUs).
The Preferred Reporting Items for a Systematic Review and Meta-analysis (PRISMA) guidelines were used. The CNKI, Wanfang Data, VIP, PubMed, Web of Science, and Embase databases were searched to collect relevant literature on the incidence of amputation in Chinese patients with DFUs. Two researchers independently screened the literature, extracted data, and evaluated the risk of bias. The data were systematically analyzed using Stata 17.0 software to determine the incidence of amputation in this patient population.
A total of 25 papers were included in the study, revealing an incidence of amputation in Chinese patients with DFUs of 22.4% (95% confidence interval: 18.3-26.5%). The subgroup analysis revealed that a history of ulcers, Wagner grade >3, and diabetic peripheral vascular disease were the primary risk factors associated with a higher incidence of amputation in Chinese patients with DFUs (<0.05). Among Chinese patients with DFUs, the amputation group and the non-amputation group showed significant differences in body mass index, duration of DFUs, total cholesterol, triglyceride, fasting blood glucose, white blood cell count, hemoglobin A1c, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, high-sensitivity C-reactive protein, and uric acid (<0.05).
The high incidence of amputation among Chinese patients with DFUs indicates that interventions should be implemented to prevent or minimize amputations.
https://www.crd.york.ac.uk/prospero, identifier CRD42023463976.
本研究旨在全面分析中国糖尿病足溃疡（DFU）患者的截肢发生率。
采用系统评价与Meta分析的首选报告项目（PRISMA）指南。检索中国知网、万方数据、维普、PubMed、Web of Science和Embase数据库，收集有关中国DFU患者截肢发生率的相关文献。两名研究人员独立筛选文献、提取数据并评估偏倚风险。使用Stata 17.0软件对数据进行系统分析，以确定该患者群体的截肢发生率。
本研究共纳入25篇论文，结果显示中国DFU患者的截肢发生率为22.4%（95%置信区间：18.3 - 26.5%）。亚组分析显示，溃疡病史、Wagner分级>3以及糖尿病外周血管疾病是中国DFU患者截肢发生率较高的主要危险因素（<0.05）。在中国DFU患者中，截肢组与非截肢组在体重指数、DFU病程、总胆固醇、甘油三酯、空腹血糖、白细胞计数、糖化血红蛋白、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、高敏C反应蛋白和尿酸方面存在显著差异（<0.05）。
中国DFU患者截肢发生率较高，表明应采取干预措施以预防或尽量减少截肢。
