糖尿病足截肢与营养学指标的相关性分析

目的从营养学角度探讨糖尿病足截肢的危险因素，为临床治疗和预防糖尿病足截肢提供临床依据。方法选择糖尿病患者共311例，分为糖尿病足截肢组、糖尿病足非截肢组、糖尿病非足病组，对三组患者的临床特征，临床检查结果及营养学相关指标进行回顾性对比分析。计量资料采用t检验，计数资料采用卡方检验，经单因素检验有统计学差异的指标进行多因素非条件logistic回归分析。结果本研究中截肢的发生率27．97％（87／311），55岁以下截肢7例，占截肢人数的8．05％（7／87），55岁以上截肢者80例，占截肢人数的91．95％（80／87）；截肢组中病程低于5年的患者20例，占截肢人数的22．99％（20／87），截肢组病程在5～10年间的11例，占截肢人数的12．64％（11／87），截肢组中病程大于10年的患者56例，占截肢人数的64．37％（56／87）。截肢组与非截肢组之间在年龄、糖尿病病程上的差异存在统计学意义（P〈0．01）；与糖尿病足截肢发生有关的独立危险因素为年龄、糖尿病病程、血清白蛋白、血红蛋白、糖化血红蛋白和超敏C反应蛋白。结论糖尿病足截肢的患者营养状况差，加强营养支持利于溃疡愈合，降低截肢风险。

Diabetic foot amputation and related nutrition indicators

Objective To determine the risk factors of diabetic foot amputation from the view of nutrition so as to provide clinical basis for treatment and prevention of diabetic foot amputation. Methods Totally 311 patients with diabetes were enrolled, and were divided into amputation group, non-amputation group, and no diabetic foot group. Clinical characteristics, clinical examination results and nutrition related indicators were retrospectively analyzed. The continuous data were examined with t test, and discrete data with chi-square test. The factors with statistical difference screened from univariate analysis underwent multivariate logistic analysis. Results The incidence of amputation was 27.97% （87/311）. Among which, there were 7 cases under 55 years old（8.05%; 7/87） and 80 cases over 55 years old （91.95%; 80/87）; 20 cases with disease course less than 5 years （22.99%; 20/87）, 11 cases with disease course ranging from 5-10 years （12.64%; 11/87）, 56 cases with disease course longer than 5 years （64.37%; 56/87）. There were significant differences in age and disease course between amputation group and non-amputation group （P 〈 0.01）. The independent risk factors of amputation for diabetic foot included age, diabetes course, serum albumin, hemoglobin, glycated hemoglobin and high-sensitivity C-reactive protein. Conclusion Patients with diabetic foot amputation suffers poor nutrition. We recommend to strengthen the nutrition support for these patients, so as to enhance ulcer healing and reduce amputation risk.