关键词: 糖尿病足, 截肢, 影响因素分析

Abstract: Background　The incidence of diabetic foot （DF） disease is high，and DF causes great harm.Awareness of the risk factors for poor prognosis in DF should be improved to aid in disease prevention and control.Objective　To analyze the characteristics of patients with DF and to explore the factors influencing severe DF and DF amputation.Methods　A total of 175 DF patients admitted to the Department of Endocrinology at Jinzhou Central Hospital between March 2012 and March 2017 were selected for this study.General patient data，laboratory test results，and diabetic complications were retrospectively collected.According to the Wagner grading standard of DF，the patients were divided into a light group and a severe group.According to amputation conditions，they were also divided into an amputation group and a non-amputation group.Multivariate Logistic regression analysis was performed to analyze the factors influencing severe DF and DF amputation.Results　The smoking rate in the severe group was higher than that in the light group.The duration of diabetes in the severe group was longer than that in the light group，and the BMI in the severe group was lower than that in the light group.The fasting C-peptide，triglyceride （TG），total cholesterol （TC），low-density lipoprotein cholesterol （LDL-C），serum albumin （Alb），alanine aminotransferase （ALT），aspartate aminotransferase （AST），red blood cell count （RBC），and hemoglobin （Hb） in the severe group were lower than those in the light group，but the homocysteine （Hcy），white blood cell count （WBC），and platelet count （PLT） in the severe group were higher than those in the light group.The incidence of diabetic nephropathy，arteriosclerosis obliterans of lower extremities，and minor amputation in the severe group were higher in the severe group than in the light group （P<0.05）.The multivariate Logistic regression analysis showed that Alb 〔OR=0.754，95%CI（0.650，0.874）〕，PLT 〔OR=1.006，95%CI（1.000，1.011）〕，and Hcy 〔OR=1.702，95%CI（1.376，2.106）〕 were associated with severe DF.In the amputation group，the smoking rate was higher，whereas the BMI was lower，than those in the non-amputation group.The levels of Alb and Hb in the amputation group were lower to those in the non-amputation group.The levels of WBC and PLT in the amputation group were higher than those in the non-amputation group.The incidence of cerebral infarction in the amputation group was higher than that in the non-amputation group （P<0.05）.The multivariate Logistic regression analysis results showed that BMI 〔OR=0.833，95%CI（0.723，0.960）〕 and Alb 〔OR=0.921，95%CI（0.872，0.974）〕 were associated with DF amputation.Conclusion　Elevated PLT and hyperhomocystinemia are risk factors for severe DF.Serum Alb is a protective factor for severe DF，and BMI and serum Alb are protective factors for DF amputation.

Key words: Diabetic foot, Amputation, Root cause analysis