糖尿病患者的足底动力学分析

背景：研究显示糖尿病足底溃疡的好发部位在足底最大承重区域。目的：分析糖尿病患者与正常人足底压力、冲量、时间等改变、分布及影响因素。设计、时间及地点：对照观察，实验于2006-05/06在首都医科大学生物医学工程学院和首都医科大学宣武医院血管外科完成。对象：选取宣武医院血管外科和内分泌科门老年糖尿病患者30例，平均年龄(71±3)岁；同时在首都医科大学退休教职工和家属中选取健康老年人为30名作对照，平均年龄(68.38±6.11)岁。方法：受试者均脱鞋以平常步态行走，使用footscan平板压力分布测试系统对其行走过程中的6组120个指标进行测定。主要观察指标:足部10个区域的峰值压力、冲量、区域支撑时间、负载率。结果：老年糖尿病患者与健康老年人共有包括左右足跖骨3区峰值压力和负载率、左足M1区冲量、左足M3区冲量、右足M3区冲量、左足T2~T5区域支撑时间8个指标差异存在显著性意义。结论：糖尿病患者足母趾和脚前掌部分受力较健康对照组大，行走时缓冲不充分，支撑时间长，是该部分容易发生溃疡的重要原因。

Dynamic analysis of foot plantar in diabetic patients

BACKGROUND: Previous studies demonstrates that plantar ulcer usually appeared on the maximum bearing region of foot. OBJECTIVE: To investigate the difference in foot plantar pressure, impulse and time between normal population and diabetics and to probe the influencing factors on the difference.DESIGN,TIME AND SETTING: The control observation was performed at the Capital Medical University School of Biomedical Engineering and the Department of Vascular Surgery, Xuanwu Hospital Capital Medical University from May to June 2006.PARTICIPANTS: A total of 30 elder diabetes patients, with average (71±3) years old enrolled in the Department of Endocrinology, and the Department of Vascular Surgery, Xuanwu Hospital Capital Medical University were selected. 30 healthy elders with (68.38±6.11) years old were served as the control group. METHODS: Each subject was evaluated with foot scan measure system, including 6 groups of 120 indexes for each barefoot.MAIN OUTCOME MEASURES: The peak pressure, impulse, regional-holding time and load rate of plantar were evaluated.RESULTS: Compared to healthy elders, 8 indexes of the impulse value of metatarsal3 (M3), the maximum of left M1, M3, right M3, and the regional-holding time of Toe 2-5 of left foot in the diabetic patients were significantly different.CONCLUSION: The main reason of plantar ulcer usually appeared on the maximum bearing region of foot is that the force of the great toe and anterior sole in the diabetic foot is larger than normal foot, which causes inadequacy walking buffer with long holding time.