糖尿病足患者肾功能和营养状态及脂质代谢与溃疡严重程度的关系

目的:探讨糖尿病足患者肾功能和营养状态及脂质代谢与溃疡严重程度的相关性。方法:选取2015年8月-2017年12月期间我院收治的糖尿病足患者389例为研究对象,根据Wagner分级将患者分为1级组52例,2级组84例,3级组96例,4级组129例,5级组28例,对比分析五组患者肾功能指标血肌酐(Scr)、胱抑素C(Cys C)、尿素氮(BUN)]、营养状态指标体重指数(BMI)、血红蛋白(Hb)、血清白蛋白(Alb)]、血脂指标甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)]水平,并分析Wagner分级与以上指标的相关性。结果:不同Wagner分级患者性别、年龄、BUN水平比较差异无统计学意义(P0.05);2级组、3级组、4级组、5级组患者的BMI、TG、HDL-C、Hb、Alb水平低于1级组,Scr、Cys C水平、吸烟史及高血压所占比例高于1级组(P0.05);4级组、5级组患者的BMI、TG、HDL-C、Hb、Alb水平低于2级组、3级组,Scr、Cys C水平、吸烟史及高血压所占比例高于2级组、3级组(P0.05)。经Spearman相关性分析显示,Wagner分级与Scr、Cys C呈正相关,与TG、HDL-C、Hb、Alb、BMI呈负相关(P0.05)。结论:糖尿病足患者Scr、Cys C与溃疡严重程度存在正相关关系,TG、HDL-C、Hb、Alb、BMI均与溃疡严重程度存在负相关关系。

Relationship between Renal Function, Nutritional Status, Lipid Metabolism and the Severity of Ulcer in Patients with Diabetic Foot

ABSTRACT Objective: To investigate the correlation between renal function, nutritional status, lipid metabolism and the severity of ulcer in patients with diabetic foot. Methods: 389 patients with diabetic foot who were admitted to our hospital from August 2015 to December 2017 were selected as the research object,according to the classification of Wagner, the patients were divided into class 1 group with 52 cases, class 2 group with 84 cases, class 3 group with 96 cases, class 4 group with 129 cases, class 5 group with 28 cases,the renal function indexesserum creatinine (Scr), Cystatin C (Cys C),urea nitrogen (BUN)], nutritional status index body mass index (BMI), hemoglobin (Hb), serum albumin (Alb) and blood lipid index],Blood lipid indextriglyceride (TG), high density lipoprotein cholesterol (HDL-C)], and the correlation between Wagner classification and the above index were analyzed. Results: There was no significant difference in gender, age and BUN level in different Wagner classification patients (P>0.05). The BMI, TG, HDL-C, Hb and Alb levels in the class 2 group, class 3 group, class 4 group, class 5 group were lower than those in the class 1 group, the proportion of Scr, Cys C, smoking history and hypertension were higher than those of class 1 group (P<0.05). The BMI, TG, HDL-C, Hb and Alb in the class 4 group, class 5 group were lower than those in the class 2 group and class 3 group, the proportion of Scr, Cys C, smoking history and hypertension were higher than those of class 2 group and class 3 group(P<0.05). The Spearman correlation analysis showed that Wagner classification was positively correlated with Scr and Cys C, and negatively correlated with TG, HDL-C, Hb, Alb and BMI (P<0.05). Conclusion: There is a positive correlation between Scr, Cys C and the severity of ulceration in diabetic foot patients, TG, HDL-C, Hb, Alb and BMI are all negatively correlated with the severity of ulcers.