中国南方与北方地区糖尿病足病危险因素分析

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目的调查并分析中国南方和北方部分医院糖尿病足病的危险因素。方法通过前瞻性地统一检查和调查方式,收集全国14家三甲医院的2004年全年门诊和住院糖尿病足病患者的社会人口学特征、代谢指标、住院天数和医疗费用等,分为南方地区和北方地区进行分析。结果 634例患者中南方地区285例,北方地区349例,南北方患者在年龄(70岁 vs 66岁)、家庭人均月收入>1000元者(57.7% vs 45.6%)、冠心病合并率(42.6% vs 61.0%)及视网膜病变合并率(35.7% vs49.5%)、糖化血红蛋白(7.90% vs 8.80%)、低密度脂蛋白胆固醇(2.75 mmol/L vs 2.98 mmol/L)、白细胞(6.70×10~9/L vs 7.40×10~9/L)、红细胞压积(HCT:0.37 vs 0.38)、肌酐(87.00μmol/L vs 76.00μmol/L)、尿酸(332.54μmol/L vs 271.40μmol/L)、住院天数(19 d vs 22 d)、足治愈率(19.1% vs10.3%)及截肢率(2.6% vs 9.7%)差异均有统计学意义,而糖尿病病程、足病病程、教育水平、吸烟率、高血压、肾脏病变及周围神经病变合并率、空腹及餐后血糖、总胆固醇、甘油三酯、高密度脂蛋白胆固醇、血小板、尿素氮在南北方地区差异均无统计学意义。Logistic 回归分析结果显示,南方地区影响糖尿病足严重程度的因素为踝肱指数(ABI)和白细胞,而北方地区的影响因素为 ABI、血小板和HCT。结论北方地区的糖尿病足病患者年龄轻,糖尿病病程长,足病病程短。影响南北方糖尿病足严重程度的共同因素为 ABI。 Objective To investigate and analyze the risk factors of diabetic foot problems in some hospitals in southern and northern China. Methods By means of prospective unified examination and investigation, the socio-demographic characteristics, metabolic indices, length of stay and medical expenses of outpatients and inpatients with diabetic foot disease in 2004 full year 2004 were collected from 14 top three hospitals nationwide and divided into southern regions and Northern region for analysis. Results A total of 634 patients were enrolled in the study. 285 patients in central south China and 349 in north China were enrolled in this study. The average age of patients in the north and south was 70 years (vs 66 years), monthly average income was> 1000 yuan (57.7% vs 45.6%), % vs 61.0% and 35.7% vs49.5%, HbA1c (7.90% vs 8.80%), LDL cholesterol (2.75 mmol / L vs 2.98 mmol / L) and white blood cells (HCT: 0.37 vs 0.38), creatinine (87.00μmol / L vs 76.00μmol / L), uric acid (332.54μmol / L vs 271.40μmol / L) ), Duration of hospital stay (19 days vs 22 days), foot cure rate (19.1% vs 10.3%) and amputation rate (2.6% vs 9.7%) were all significantly different from each other, but the duration of diabetes, duration of podiatry, education level Smoking, hypertension, nephropathy and peripheral neuropathy, fasting and postprandial blood glucose, total cholesterol, triglyceride, high density lipoprotein cholesterol, platelet and urea nitrogen were not significantly different between north and south. Logistic regression analysis showed that the factors affecting the severity of diabetic foot in the south were ankle brachial index (ABI) and white blood cells, while the influencing factors in the north were ABI, platelets and HCT. Conclusion The patients with diabetic foot disease in the northern region are young, have longer duration of diabetes and shorter duration of podiatry. The common factor that affects the severity of diabetic foot disease in North and South is ABI.
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