糖尿病患者足底压力分布及其影响因素

目的：了解糖尿病患者和正常人群足底压力峰值、分布情况及其主要因素。方法：采用足底压力测量仪检测218例糖尿病患者和102例健康正常人以正常步态行走时的动态足底压力，每个受试者均检测5次后取平均值。将足底分为10个不同区域，计算平均足底最大峰值压力（MPP）和足底各区域MPP的分布情况。结果：正常人群和糖尿病患者足底MPP分别为（402±129）kPa和（417±113）kPa，在调整了年龄、性别、BMI等协变量的影响后，两组间的差异无统计学意义（P〉0．05）。糖尿病组第1跖骨、第5跖骨区压力高于正常人群。多元线性回归分析结果显示，其中合并周围神经病变和胼胝2个因素进入回归方程，这2个因素可解释足底压力总变异量的38．2％。结论：糖尿病患者和正常人群之间MPP无差别，但压力分布不同。合并周围神经病变和胼胝的形成可显著影响糖尿病患者足底压力。

Plantar pressure distribution and analysis of correlated factors in diabetic patients: a pilot study

Objective：To examine the peak value, distribution and correlated factors of plantar pressure in normal population and diabetics. Methods：EMED-AT plantar pressure system was used to measure the plantar pressure in 218 diabetic patients and 102 non-diabetic subjects during barefoot walking with usual gaits. The measurements were repeated 5 times and recorded as mean values for each subject. Mean maximum peak pressure （MPP） and distribution of MPP at the whole or 10 defined regions of planta were calculated. Results：The mean MPP（maximum peak pressure） of whole-planta was 402 ± 129 kPa in normal subjects vs 417 ± 113 kpa in diabetics. There was no significant difference in MPP between the two groups after adjusting for age, sex, BMI and other related variables （ P 〉 0. 05 ）. Higher levels of MPP were recorded in diabetics compared with normal subjects at the forefoot and heel. Based on multiple linear regression analysis, the MPP levels of diabetics were positively correlated with diabetic peripheral neuropathy（DPN） and callus. These two factors may explain for an overall variation of 38. 2% in plantar pressure of the subjects. Conclusions： Diabetic patients and normal population did not differ in level but in distribution of plantar pressure. Complicating DPN and formation of callus can significantly affect the plantar pressure in patients with diabetes.