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

摘要： 背景　糖尿病足（DF）发病率高、预后差，既往研究表明糖尿病视网膜病变（DR）与DF发生呈正相关，但DR与DF不良预后的相关性尚不清楚。目的　分析DR与重症DF及DF截肢的相关性。方法　选取2015年12月—2018年12月于锦州市中心医院内分泌科住院的DF患者96例为研究对象，根据Wagner分级分为轻症组47例、重症组49例，根据是否截肢分为非截肢组74例、截肢组22例。比较轻症组和重症组、非截肢组和截肢组一般资料、实验室指标及并发症/合并症的发生情况，采用Logistic回归分析重症DF和DF截肢的影响因素。结果　96例DF患者中，重症DF 49例（51.0%），DF截肢者22例（22.9%）。重症组吸烟者占比、白细胞计数（WBC）高于轻症组，空腹血糖（FBG）、血清白蛋白（ALB）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）、血红蛋白（HGB）、脂代谢异常发生率低于轻症组（P<0.05）；轻症组和重症组DR分期比较，差异有统计学意义（P<0.05）。截肢组糖尿病（DM）病程、吸烟者占比高于非截肢组，TG、高血压患病率低于非截肢组（P<0.05）；非截肢组与截肢组DR分期比较，差异有统计学意义（P<0.05）。Logistic回归分析结果显示，吸烟情况、TG水平、DR分期是重症DF的影响因素，吸烟情况、DR分期、高血压患病情况是DF截肢的影响因素（P<0.05）。DR分期越高，患者重症DF发生率越高（P<0.05），但DF截肢发生率差异并无此情形（P>0.05）。结论　DR分期为重症DF及DF截肢的影响因素，伴随DR病变逐渐加重，重症DF发生率逐渐增加，DR可作为重症DF发生的有效预测因子。

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