糖尿病周围神经病变患者足底压力与步态的变化

发布时间：2018-02-26 12:53

本文关键词： 糖尿病周围神经病变足底压力步态　出处：《广东医学》2017年06期 　论文类型：期刊论文

【摘要】：目的了解2型糖尿病合并周围神经病变患者的足底压力与步态变化。方法纳入住院的303例2型糖尿病患者,分为糖尿病无周围神经病变组(DC组)和糖尿病周围神经病变组(DPN组)。收集患者一般资料、相关生化指标。使用Foot Scan系统收集足底压力及步态相关参数。采用独立样本t检验、Mann-Whitney U检验、Spearman秩相关进行数据分析。结果与DC组相比,DPN组左足第3、4跖骨的峰值压力降低[(13.15±4.22)N/cm~2vs(11.96±3.94)N/cm~2,P0.05;(10.21±4.22)N/cm~2vs(9.14±3.66)N/cm~2,P0.05],右足第1、2、3跖骨峰值压力降低[(6.02±2.79)N/cm~2vs(5.04±2.87)N/cm~2,P0.05;(9.95±2.69)N/cm~2vs(9.18±2.77)N/cm~2,P0.05;(10.90±3.23)N/cm~2vs(9.93±3.09)N/cm~2,P0.05],其余区域峰值压力、总应力、总接触面积、总应力-时间积分、各区域压力-时间积分的组间差异均无统计学意义(P0.05)。与DC组相比,DPN组右足的整足接触阶段[56.8%(50.22%~62.45%)vs 59.5%(54.25%~64.15%),P0.05]延长,离地阶段[31.25%(25.475%~35.775%)vs 29%(24.95%~33.65%),P0.05]缩短,总时间[(858±12)ms vs(900±127)ms,P0.05]延长,步行速度[(2.58±0.67)km/h vs(2.28±0.66)km/h,P0.05]减慢。步行速度与多个区域的足底压强呈正相关(P0.05),支撑相中的整足接触阶段与峰值压力呈负相关(P0.05),离地阶段与峰值压力呈正相关(P0.05)。结论糖尿病周围神经病变患者足底压力峰值、压力-时间积分未见升高,步行速度减慢,整足接触阶段延长,离地阶段缩短。对糖尿病患者足底压力进行评价同时需要对步行速度及步态进行矫正,使用压力-时间积分指标更能反映足底承受压力情况。
[Abstract]:Objective to investigate the changes of plantar pressure and gait in patients with type 2 diabetes mellitus complicated with peripheral neuropathy. The patients were divided into two groups: diabetic group without peripheral neuropathy (DC group) and diabetic peripheral neuropathy group (DPN group). Correlation biochemical indexes. The plantar pressure and gait related parameters were collected by Foot Scan system. The data were analyzed by independent sample t-test Mann-Whitney U test. The results showed that the peak pressure of the third metatarsal bone of left foot in DC group was higher than that in DC group. The peak pressure of the metatarsal bone in the first metatarsal of the right foot was decreased [13.15 卤4.22 N- / cm ~ 2 vs 11.96 卤3.94 N / cm ~ (-2) N 路min ~ (-1) ~ 11.96 卤3.94 N / cm ~ (2)) ~ (10.21 卤4.22 卤4.22 卤3.66) N 路cm ~ (2 +) respectively, the peak pressure of the first metatarsal bone of the right foot was decreased [[6.02 卤2.79 N 路cm ~ (-1) (5.04 卤2.87) N / cm ~ (2)], and the peak pressure in the rest of the region was 9.93 卤3.09Ncm / cm ~ (-2), and the peak pressure in the rest area was 9.95 卤2.69N / cm ~ (-2) N / cm ~ (-1) ~ (9.18 卤2.77) N 路cm ~ (-2) N 路min ~ (-2) N 路cm ~ (-1), the peak pressure of the metatarsal bone of the first metatarsal of the right foot was 9.93 卤3.09 卤3.09 N / cm ~ (-2). There was no significant difference in total stress, total contact area, total stress-time integral, pressure time integral between groups. Compared with DC group, the whole foot contact stage of right foot in DPN group was increased [56.80.222.45 / 59.54.254.64.15p0.05], and the distance was shortened in the leaving ground stage [31.252525.475v 35.775v vs 292.9524.9565], and there was no significant difference between the two groups in the total stress, total contact area, total stress-time integral and pressure / time integral in all regions. The whole foot contact stage in the DPN group was shorter than that in the DC group (56.80.222.45 vs 59.54.64.15p0.05), and the distance between the two groups was shortened. The total time [858 卤12 Ms vs(900 卤127 Ms] was prolonged. The walking speed [2.58 卤0.67km / h vs(2.28 卤0.66km / h] slowed down. There was a positive correlation between walking speed and plantar pressure in several regions (P0.05A). The whole foot contact stage in support phase was negatively correlated with peak pressure (P0.05U), and the off-ground stage was positively correlated with peak pressure (P0.05A). Conclusion\\\;\\;\\;\\;\\; Peak plantar pressure in patients with neuropathy, The pressure-time integral did not increase, the walking speed slowed down, the whole foot contact stage was prolonged, and the off-ground stage was shortened. The foot pressure of diabetic patients was evaluated and the walking speed and gait were corrected. The use of pressure-time integral index can better reflect foot pressure.
【作者单位】：南方医科大学南方医院内分泌代谢科;
【基金】：广东省科技计划项目(编号:2013B022000063)
【分类号】：R587.2

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