糖尿病足严重程度评估指标的相关性分析

Correlation analysis of evaluation indicators of diabetic foot severity

摘要:

目的探讨糖尿病足Wagner分级相关的评估指标。方法选取2001 年11 月-2015 年4 月于解放军空军总医院收治的1 578 例糖尿病足（DF）患者（排除1 型、特殊类型DM 足患者21 例，Wagner 0级28 例，以及数据缺失较大193 例）临床资料，依据Wagner 分级分为5 组，对5 组间资料进行方差分析、χ2检验和Spearmen 等级相关性分析。结果1 578 例DF 患者中，Wagner 1～5 级分别为73 例（4.6%）、241 例（15.3%）、280 例（17.7%）、945 例（59.9%）及39 例（2.5%）。随着Wagner 分级的增高，DF 患者的C 反应蛋白（CRP）、血沉（ESR）、铁蛋白、住院费用、糖化血红蛋白（HbA1c）、空腹血糖（FBG）、住院时间偏高，糖尿病周围血管病变（PAD）、糖尿病周围神经病变（DPN）、糖尿病视网膜病变（DR）的发病率也偏高，而血红蛋白（Hb）及体重指数（BMI）偏低，差异有统计学意义（P <0.05）。相关性分析显示，PAD、DPN、HbA1c、FBG 及感染指标（CRP、ESR、铁蛋白）与DF严重程度呈正相关（P <0.05）；而营养指标（Hb、BMI）与DF严重程度呈负相关（P <0.05）。结论PAD、DPN、HbA1c、FBG、感染以及全身营养状况与DF严重程度相关。

Abstract:

Objective To explore the correlation between the severity of diabetic foot (DF) and evaluation indicators. Methods The clinical data of 1,578 patients with DF at the Air Force General Hospital from November 2001 to April 2015 were retrospectively analyzed [excluding 21 type 1 and special type diabetes mellitus (DM) patients, 28 DM patients with Wagner 0 grade and 193 patients with a large number of missing data]. All the patients were divided into five groups according to the Wagner grade. Variance analysis and chi-square test were used among five groups and Spearmen analysis was used to evaluate the correlation between the selected indicators and Wagner grade. Results Among 1,578 patients with DF ulcers, there were 73 (4.6%) patients in Wagner 1 grade, 241 (15.3%) in Wagner 2 grade, 280 (17.7%) in Wagner 3 grade, 945 (59.9%) in Wagner 4 grade and 39 (2.5%) in Wagner 5 grade. With the increase of Wagner grade, C-reaction protein (CRP), erythrocyte sedimentation rate (ESR), ferritin, hospital stays, hospitalization expenses, glycosylated hemoglobin (HbA1c), fasting blood-glucose (FBG) and the incidences of peripheral arterial disease (PAD), diabetic peripheral neuropathy (DPN) and diabetic retinopathy (DR) increased, while hemoglobin (Hb) and body mass index (BMI) decreased. Spearmen analysis showed that PAD, DPN, HbA1c, FBG and infectious indexes (CRP, ESR and ferritin) were positively correlated with DF severity while nutritive indexes (Hb and BMI) were negatively correlated with it (P < 0.05). Conclusions PAD, DPN, HbA1c, FBG, infection factors and nutritional factors are regarded to be closely associated with the DF severity.