摘要
目的基于Logistic回归模型及ROC曲线的糖尿病足溃疡(DFU)复发的危险因素分析。方法回顾性选取2018年9月—2019年9月本院收治的92例初发2型糖尿病(T2DM)足溃疡患者,根据3年内足溃疡复发情况分为非复发组51例与复发组41例,行DFU患者足溃疡复发的单因素分析,多因素Logistic模型研究DFU患者足溃疡复发的危险因素,Spearman检验分析各指标与DFU患者足溃疡复发的相关性,受试者工作特征曲线(ROC)评价模型诊断效能。结果92例DFU患者随访3年,复发41例,复发率为44.57%。单因素分析显示,两组体质量指数(BMI)、性别、心脑血管疾病病史占比、高血压病史占比、住院时间、发病至就诊时间、ALB、TBIL、Scr、HbA1c、TG、HDL、TC、LDL差异无统计学意义(P>0.05);与非复发组比较,复发组年龄、T2DM病程、糖尿病周围神经病变(DPN)占比、下肢外周动脉病变(PAD)占比、吸烟史占比、创面位于胼胝占比明显升高,TBIL水平明显降低(均P<0.05)。多因素分析显示,年龄增大、T2DM病程长、合并DPN、合并PAD、有吸烟史、创面位于胼胝及血清TBIL水平降低为DFU患者足溃疡复发的危险因素(P<0.05)。Spearman检验提示,DFU患者足溃疡复发与年龄、T2DM病程、DPN、PAD、吸烟史、创面位于胼胝呈正相关,TBIL水平明显降低呈负相关(均P<0.05)。以unite(七变量综合)、年龄、T2DM病程、TBIL、DPN、PAD、吸烟、创面位于胼胝为检验变量绘制ROC曲线,结果显示,unite的AUC值为0.834,分别大于年龄(0.632)、T2DM病程(0.619)、TBIL(0.645)、DPN(0.684)、PAD(0.662)、吸烟(0.640)、创面位于胼胝(0.677),提示7项指标联合应用于评估DFU患者足溃疡复发的效能明显优于单一指标(P<0.05)。结论年龄增大、T2DM病程长、合并DPN、合并PAD、有吸烟史、创面位于胼胝、血清TBIL水平降低为DFU患者足溃疡复发的危险因素,如发现上述情况应高度警惕DFU患者足溃疡复发风险,并尽早干�
Objective To analyze the risk factors of recurrent foot ulcer(DFU)in diabetes patients based on Logistic regression model and ROC curve.Methods 92 patients with foot ulcer of newly diagnosed type 2 diabetes mellitus(T2DM)admitted to our hospital from September 2018 to September 2019 were retrospectively selected.They were divided into non recurrence group(51 cases)and recurrence group(41 cases)according to the recurrence of foot ulcer within three years.Single factor analysis of foot ulcer recurrence in DFU patients was performed.Multifactor logistic model was used to study the risk factors of foot ulcer recurrence in DFU patients.Spearman test was used to analyze the correlation between each index and foot ulcer recurrence in DFU patients.The diagnostic efficacy of the model was evaluated by the receiver operating characteristic curve(ROC).Results 92 cases of DFU were followed up for 3 years,41 cases recurred,the recurrence rate was 44.57%.Univariate analysis showed that there was no significant difference(P>0.05)between the two groups in body mass index(BMI),gender,history of cardiovascular and cerebrovascular diseases,history of hypertension,length of stay,time from onset to visit,ALB,TBIL,Scr,HbA1c,TG,HDL,TC,and LDL.Compared with the non recurrent group,the age,T2DM course,the proportion of diabetes peripheral neuropathy(DPN),the proportion of lower limb peripheral arterial disease(PAD),the proportion of smoking history,and the proportion of wound located in the callus in the recurrent group increased significantly,and the TBIL level decreased significantly(all P<0.05).Multivariate analysis showed that the risk factors of foot ulcer recurrence in DFU patients were age,long duration of T2DM,DPN,PAD,smoking history,wound location in the callus and decreased serum TBIL level(P<0.05).Spearman test showed that the recurrence of foot ulcer in DFU patients was positively correlated with age,T2DM course,DPN,PAD,smoking history,and wound location on the callus,while the level of TBIL was significantly decreased and ne
作者
周慧超
孙珂
许聿新
井庆平
ZHOU Huichao;SUN Ke;XU Yuxin;JING Qingping(The First Hospital of Zibo,Zibo 255200,Shandong,China)
出处
《西部医学》
2024年第5期744-748,共5页
Medical Journal of West China
基金
国家自然科学基金项目(82004369)
山东省医药卫生科技发展计划项目(202103060185)。
