糖尿病足患者临床的的特点及皮肤组织学结构改变.docVIP

糖尿病足患者临床的的特点及皮肤组织学结构改变 　　【摘要】 目的：?{查和分析本院住院糖尿病足患者临床特点与周围神经病变、下肢血管病变的关系；观察糖尿病足溃疡伤口皮肤组织学结构改变。方法：对2014年6月-2016年5月在本院住院的糖尿病足患者进行调查分析，并观察糖尿病足病溃疡边缘皮肤组织学结构的改变。结果：纳入统计糖尿病足患者227例。糖尿病足患者227例中，合并高血压病122例（53.7%），合并血脂异常147例（64.8%），存在下肢血管病变144例（63.4%），存在周围神经病变150例（66.1%），空腹血糖达标率仅15.4%，餐后血糖达标率12.8%，HbA1c达标率仅8.4%，TC达标率23.3%，未合并冠心病糖尿病足患者LDL-C达标率12.2%，合并冠心病患者达标率16.7%。糖尿病足病患者多合并高血压、血脂异常；且存在外周血管病变及周围神经病变；具有年龄大、病程长及血糖血脂水平控制不佳的特点。多元逐步回归分析显示年龄、糖尿病病程、HbA1c为显示影响足部溃疡程度Wagner分级的显著因素；其中HbA1c的影响最大（OR=1.278）；Hb为T2DM发生糖尿病足的保护因素（OR=0.960）。HE染色光镜下观察到糖尿病足病组皮肤组织学结构发生改变。结论：糖尿病足病患者多合并高血压、血脂异常；且存在外周血管病变及周围神经病变；具有年龄大、病程长及血糖控制不佳的特点。糖尿病足病组皮肤与正常皮肤比较具有典型组织学改变。 　　【关键词】 糖尿病足； 周围神经病变； 下肢血管病变； 危险因素； 皮肤组织学改变 　　Clinical Characteristics and Ulcer Marginal Changes in the Structure of Skin of Diabetic Foot Patients/LIN Chu-jia，GUO Pei-xiang，LIN Jia-hui，et al.//Medical Innovation of China，2017，14（02）：053-057 　　【Abstract】 Objective：To study the relation between clinical characteristics of the diabetic foot patients and peripheral neuropathy and peripheral artery disease.And to observe the ulcer marginal histological changes in the skin of the diabetic foot.Method：Patients with diabetic foot were surveyed from June 2014 to May 2016 hospitalized in our hospital，including demographic data，history of the foot，the classification and phases of the foot ulcers based on the Wagner’ system，the peripheral artery disease characteristics，the peripheral nerologic disorder characteristics and other relative risk factors.Then we observed the structure of skin in the diabetes foot ulcer marginal changes with HE staining.Result：227 diabetic patients with foot problems were analyzed.There were 　　122 cases（53.7%） with hypertension，and 147 cases（64.8%） with dyslipidemia.There were 144 cases（63.4%） with peripheral artery disease（PAD），and there were 150 cases（66.1%） with peripheral neuropathy.The diabetic foot patients had the characteristics of old age，long duration and poor control of blood glucose and blood lipid.Stepwise regressio