摘要
目的分析糖尿病足溃疡的危险因素及预防性检查的临床情况,为临床工作提供参考依据。方法选择河北大学附属医院2009年10月-2012年10月收治的糖尿病患者50例作为研究对象,其中糖尿病足及非糖尿病足者各25例,分析糖尿病足患者的危险因素,并选择同期本院健康体检者20例作为对照,观察所有研究对象的凝血指标、下肢肌电图和超声检查结果。结果糖尿病患者的周围血管病变、周围神经病变以及足底生物力学变化为发生足溃疡的危险因素,糖尿病患者的凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)均明显增高,与健康者比较差异有统计学意义(P<0.05),并且糖尿病足患者与非糖尿病足患者比较,以上指标的变化更为明显(P<0.05);糖尿病足患者的下肢肌电图和超声检查异常比例达到84.0%、92.0%,明显高于另外两组,差异有统计学意义(P<0.05)。结论糖尿病患者周围血管病变、周围神经病变以及足底生物力学变化均为发生足溃疡的危险因素,凝血指标、下肢肌电图和超声检查对糖尿病足溃疡具有临床诊治意义,可以作为预防性检查项目。
Objective To investigate the risk factors and clinical values of preventive testing for diabetic foot ulcer, and to provide evidences for the clinical practice. Methods Fifty patients with diabetes mellitus hospitalized in the Affiliated Hospital of Hebei University from October 2009 to October 2012 were selected to serve as the research objects. They were divided into di- abetic foot group and non- diabetic foot group （each n = 25）. 20 physical examinees were simultaneously chosen as controls. The coagulation indexes, lower limb EMG and ultrasound results of all objects were observed. Results The diabetes patients＇ pe- ripheral vascular disease, peripheral neuropathy and the changes of foot biomechanies were all risk factors for diabetic foot ulcers. The prothromhin time （PT） and activated partial thromboplastin time （AFI＇T）, fibrinogen （FIB） of diabetes patients were all significantly increased, there were statistically significant differences in above indicators between diabetes patients and healthy controls （P 〈 0.05） as well as between diabetic foot group and non- diabetic foot group （P〈 0.05）. The abnormal proportions of lower limb electromyography and ultrasound in diabetic foot patients were 84.0 % and 92.0 %, respectively, which were both significantly higher than those of other two groups, and the differences were statistically significant （ P 〈 0. 05 ）. Conclusions Peripheral vascular disease, peripheral neuropathy and changes in foot biomechanics are risk factors for occurring foot ulcer in diabetic patients. The coagulation indexes, lower limb EMG and ultrasound results show clinical values in the diagnosis and treatment of diabetic foot ulcer, which can be used as the preventive examination items.
出处
《实用预防医学》
CAS
2013年第2期240-241,共2页
Practical Preventive Medicine
