关键词: 糖尿病, 糖尿病视网膜病变, 糖尿病足, 截肢术, 危险因素, 预测因子

Abstract: WANG Xueying，Professor，Chief physician；E-mail：xue5539@foxmail.com
Background　Diabetic foot（DF）is characterized by high incidence and poor prognosis.Previous studies have shown that diabetic retinopathy（DR）is positively correlated with DF.But the correlation between DR and adverse prognosis of DF is not clear.Objective　To analyze the relationship of DR with severe DF and DF amputation.Methods　96 DF patients hospitalized in Department of Endocrinology，Jinzhou Central Hospital from December 2015 to December 2018 were selected，including 47 with mild and moderate DF（mild-moderate group），and 49 with severe DF（severe group）graded by Wagner classification；22 with amputation（amputation group），and 74 without（non-amputation group）divided by the prevalence of amputation.The general data，laboratory indicators and complications/comorbidities were compared between mild-moderate and severe groups，and between amputation and non- amputation groups.The influencing factors of severe DF and DF amputation were analyzed by Logistic regression.Results　Among the participants，the rates of severe DF，and DF amputation were 51.0%（49/96），and 22.9%（22/96），respectively.Compared with mild-moderate group，severe group showed higher rate of smokers，and higher mean white blood cell count（WBC） level，and lower mean fasting blood glucose（FBG），serum albumin（ALB），triglycerin（TG），low density lipoprotein cholesterol（LDL-C） and  hemoglobin（HGB） levels as well as lower rate of abnormal lipid metabolism（P<0.05）.Moreover，two groups also showed significant differences in stages of DR（P<0.05）.Compared with non-amputation group，amputation group had longer mean duration of diabetes，and higher rate of smokers，as well as lower mean TG level and hypertension prevalence（P<0.05）.Furthermore，these two groups also demonstrated significant differences in stages of DR（P<0.05）.Logistic regression analysis showed that smoking，TG level and DR stage were the influencing factors of severe DF.Smoking，DR stage and hypertension were the influencing factors of DF amputation（P<0.05）.The more advanced the stage of DR was，the higher the incidence of severe DF became（P<0.05），howere，there was no difference in the incidence of DF between the two groups．Conclusion　DR is an independent risk factor for severe DF and DF amputation.With the progression of DR lesions，the incidence of severe DF increases gradually.DR can be used as an effective predictor of severe DF.

Key words: Diabetes mellitus, Diabetic retinopathy, Diabetic foot, Amputation, Risk factors, Predictive factors