摘要
目的调查和分析糖尿病足下肢血管病变特点及相关因素。方法对2005年至2009年门诊和住院糖尿病足患者进行调查,包括病史回顾、体格检查、生化检查及下肢血管检查和周围神经检查;对足溃疡进行分类、分级,进行下肢病变特点的分析及足溃疡影响因素的相关分析。结果纳入本研究的糖尿病足患者共258例,缺血性溃疡179例(69.38%),其中单纯性缺血性足部溃疡患者92例(35.66%),合并神经性溃疡的混合性溃疡患者87例(33.72%);单纯神经性溃疡79例(30.62%)。足部缺血性溃疡患者足病中位病程〔6(1,95)个月〕明显长于神经性溃疡患者〔3(1,63)个月〕(P<0.01),混合性溃疡患者足病中位病程〔13(1,106)个月〕长于单纯神经性溃疡患者及缺血性溃疡患者(P均<0.01)。缺血性足病组及混合性足病组溃疡深度明显较深。缺血性足病患者截肢(趾)率明显高于神经性溃疡足病患者(31.84%vs13.92%,P<0.01)。多元逐步回归分析显示影响足部溃疡程度W agner分级的较显著因素为左足踝肱指数(AB I)、右足AB I及经济收入。结论糖尿病足溃疡患者中缺血性溃疡及混合性溃疡多见,下肢血管病变发病率高;缺血性溃疡溃疡深,愈合慢,截肢(趾)率高,预后差。足部神经病变与缺血病变相互影响加重足病病情。AB I检查是糖尿病足下肢血管病变简单实用的检查方法。
Objective To investigate the clinical characteristics of diabetic foot with peripheral artery disease（PAD） and the related factors of foot ulcer.Methods A total of 258 out-or in-patients with diabetic foot from 2005 to 2009 were enrolled in this study.Standard tabulation,including history,physical examination,control condition of hyperglycemia and dyslipidemia,classification and degree of foot ulcer,etc.was made and filled in.The examinations of vessel and peripheral nerve in lower limb were carried out,and the related factors of foot ulcer were analyzed.Results Of 258 type 2 diabetic patients with foot ulcer,179 cases（69.38%） were ischemic ulcer including 92 cases（35.66%） of simple ischemic ulcer and 87 cases（33.72%） combined with neurogenic ulcer（mixed ulcer）,and 79 cases（30.62%） were simple neurogenic ulcer.The course of diabetic foot in patients with PAD was apparently longer than that in patients with simple neurogenic ulcer（P0.01）.The depth of mixed ulcer was obviously deeper than that of simple neurogenic ulcer（P0.05）.The rate of amputation in the patients of diabetic foot with ischemic ulcer was markedly higher than that in patients with neurogenic ulcer（31.84% vs 13.92%,P0.01）.Multivariate stepwise regression analysis showed that left foot ABI,right foot ABI and economic income were the most significant agents affecting the degree of ulcer.Conclusions The ischemic ulcer in diabetic foot is common and has characteristics of deeper ulcer,slower healing,higher amputation rate and worse prognosis.The ABI is a simple and practical examination method of PAD in diabetic foot.
出处
《中国临床研究》
CAS
2011年第4期274-276,279,共4页
Chinese Journal of Clinical Research
关键词
糖尿病足
周围血管病变
下肢
溃疡
缺血性
神经性
Diabetic foot
Peripheral artery disease
lower limb
Ulcer
ischemic
neurogenic
