糖尿病足溃疡患者的贫血：患病率、临床特征及预后

发布时间：2018-02-27 13:53

本文关键词： 糖尿病足贫血预后　出处：《重庆医科大学》2015年硕士论文　论文类型：学位论文

【摘要】：目的：回顾分析糖尿病足溃疡患者合并贫血的患病率、临床特征及预后,并评估贫血对糖尿病足溃疡预后的影响。材料和方法：回顾性的研究我院353名糖尿病足溃疡患者,根据患者入院时有无贫血将其分为贫血组及非贫血组,比较两组患者分别在人口统计学特征、实验室检查结果、糖尿病并发症、合并症、治疗方案、糖尿病足溃疡特征及预后等方面的差异。本研究的主要研究终点为良好结局(愈合)和不良结局(未愈合、截肢、死亡),次要研究终点为截肢以及死亡。结果：调查的353名糖尿病足溃疡患者,平均年龄为66.44岁,其中236名合并贫血,所占比例为66.9%。单因素分析发现糖尿病足溃疡合并贫血的患者多为男性,有吸烟史、血清白蛋白水平更低、肾功能更差、全身使用至少两类抗生素、下肢的血流灌注更差、足溃疡面积更大、深度更深、感染更重。多因素回归分析表明,男性、血清白蛋白水平更低、肾功更差是糖尿病足溃疡患者合并贫血的独立危险因素。并通过多因素分析得出贫血是糖尿病足溃疡不良结局的独立危险因素。通过ROC曲线分析确定糖尿病足溃疡患者易发生不良结局的血红蛋白适宜切点为：女性12.3g/dL,男性12.1g/dL。结局：贫血在糖尿病足溃疡患者中非常常见,尽管其中绝大多数为轻、中度贫血,但却与糖尿病足溃疡患者的病残率及死亡率息息相关。
[Abstract]:Objective: to retrospectively analyze the prevalence, clinical characteristics and prognosis of diabetic foot ulcers complicated with anemia, and evaluate the influence of anemia on the prognosis of diabetic foot ulcers. Materials and methods: 353 diabetic foot ulcers were retrospectively studied in our hospital. According to whether the patient had anemia at admission, they were divided into anemia group and non-anemia group. The two groups were compared in terms of demographic characteristics, laboratory results, diabetic complications, complications, and treatment plans. The main endpoints of this study were good outcome (healing) and bad outcome (non-union, amputation, etc.). Results: the average age of 353 patients with diabetic foot ulcers was 66.44 years old, 236 of them complicated with anemia. Univariate analysis showed that the majority of diabetic foot ulcers complicated with anemia were male, had a history of smoking, had lower serum albumin levels, had worse renal function, used at least two kinds of antibiotics throughout the body, and had worse blood perfusion in the lower extremities. Foot ulcers were larger, deeper, and more infected. Multivariate regression analysis showed that men had lower levels of serum albumin. Kidney dysfunction is an independent risk factor for diabetic foot ulcer patients with anemia. Anemia is an independent risk factor for the adverse outcome of diabetic foot ulcers. ROC curve analysis is used to determine the diabetic foot ulcers. The optimal hemoglobin cutting point for patients with poor outcomes is: women 12.3g / dL, men 12.1g / dL. outcome: anemia is very common in patients with diabetic foot ulcers. Although most of them are mild and moderate anemia, they are associated with disability and mortality in patients with diabetic foot ulcers.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R587.2

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