糖尿病足溃疡患者截肢相关因素分析

目的 探讨住院糖尿病足溃疡(DFU)患者截肢的相关因素,为降低DFU截肢风险提供理论依据.方法 2013年10月至2015年12月收治于该院的307例DFU患者,按是否接受截肢手术分为截肢组(28例)和非截肢组(279例),对两组患者的临床特征及实验室指标进行单因素分析,并采用多因素非条件Logistic回归分析探讨截肢的相关因素.结果 截肢组患者的住院时间、超敏C反应蛋白(hs-CRP)及纤维蛋白原(FIB)水平均明显高于非截肢组(P＜0.05),血红蛋白(Hb)、高密度脂蛋白(HDL)及血清清蛋白(ALB)水平明显低于非截肢组(P＜0.05).两组患者不同Wagner分级截肢情况分布比较差异也有统计学意义(P=0.000).多因素非条件Logistic回归分析发现住院时间(OR=1.024;95％CI:1.009～1.039),Wagner分级(OR=2.779;95％CI:1.753～4.404)是DFU患者截肢的独立危险因素,HDL是DFU截肢的保护性因素(OR=0.161;95％CI:0.036～0.729).结论 DFU患者Wanger分级越高,住院时间越长,截肢风险越高,HDL是DFU截肢的保护性因素.

Analysis of related factors of diabetes foot ulcer amputation

Objective To explore related factors of amputation in patients with diabetes foot ulcer(DFU) and provide the evidence of reducing amputation rate.Methods A total of 307 inpatients with DFU in this hospital from October 2013 to December 2015 were collected and divided into amputation group(n=28) and non-amputation group(n=279).The clinical data and laboratory data were treated with single variable analysis and multivariate Logistic regression analysis.Results Single variable analysis showed that hospitalization time,hyper-sensitive C-reactive(hs-CRP) and fibrinogen(FIB) level were significantly increased in amputation group(P＜0.05) when compared with non-amputation group,and the hemoglobin (Hb) level,high-density lipoprotein cholesterol(HDL) and serum albumin (ALB) level in amputation group were markedly lower than in non-amputation group(P＜0.05).Amputation rate was significantly different among different Wagner grades (P=0.000).Multivariate Logistic regression analysis showed that hospitalization time,Wagner grade were independent risk factors of amputation in patients with DFU,OR values were 1.024(95％CI:1.009-1.039) and 2.779 (95％CI:1.753-4.404),respectively.While HDL was a protective factor of amputation in patient with DFU (OR=0.161;95％CI:0.036-0.729).Conclusion The higher the rank of Wanger in DFU patients are,the longer hospital stay and the higher amputation risk become.HDL is the protective factor of DFU amputation.