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糖尿病足患者Wanger分级及抗生素用药频度的相关危险因素分析
作者:张学丽1  董韩2  刘德林3  邵华1 
单位:1. 东南大学附属中大医院 药学部, 江苏 南京 210009;
2. 中国药科大学 基础医学与临床药学学院, 江苏 南京 211198;
3. 东南大学附属中大医院 内分泌科, 江苏 南京 210009
关键词:糖尿病足 Wanger分级 抗生素用药频度 危险因素 
分类号:R587.2;R978.1
出版年·卷·期(页码):2019·38·第五期(818-824)
摘要:

目的:探讨住院糖尿病足患者Wanger分级及抗生素用药频度的相关危险因素。方法:选取2013年7月至2016年9月在东南大学附属中大医院就诊的429例糖尿病足患者为研究对象,采用回顾性分析研究方法,收集患者年龄、相关生化指标、抗生素使用相关情况、病原菌培养及多药耐药情况、基础合并疾病、糖尿病足Wanger分级以及出院时溃疡预后情况等指标,进行多元线性回归和有序Logistic回归分析。结果:根据纳入排除标准,最后筛选出280例符合要求的病例。有序Logistic回归分析发现,年龄(P<0.01)、血清白蛋白(P<0.01)、糖尿病病程(P<0.05)、双下肢血流动力学评估情况(P<0.01)为糖尿病足Wanger分级的危险因素;多元线性回归分析发现,年龄(P<0.01)、合并肾脏疾病(P<0.05)、血清白蛋白(P<0.01)为抗生素用药频度的危险因素。结论:年龄相对小、血清白蛋白水平低、糖尿病病程长、双下肢血流动力学评估情况差的患者足病Wanger分级更高;而年龄相对小、血清白蛋白水平低、未合并肾脏疾病的糖尿病足患者抗生素用药频度大。

Objective: To analyze the risk factors of Wanger classification and antibiotic defined daily doses(DDDs) in hospitalized diabetic foot patients. Methods: 429 patients with diabetic foot in Zhongda Hospital Affiliated to Southeast University from July 2013 to September 2016 were selected as the subjects. The basic information of age, biochemical index, antibiotic utilization, pathogen culture and multidrug resistance, complication, diabetic foot, and prognosis of ulcer at discharge were collected by retrospective analysis. Multiple linear regression and ordered Logistic regression were used to analyze the data. Results: According to inclusion and exclusion criteria, 280 eligible cases were finally included. Ordered Logistic regression analysis showed that age (P<0.01), serum albumin (P<0.01), duration of diabetes mellitus (P<0.05) and hemodynamic assessment of both lower limbs (P<0.01) were risk factors for diabetic foot classification;multiple linear regression analysis showed that age (P<0.01), kidney disease (P<0.05) and serum albumin (P<0.01) were the related risk factors of DDDs of antibiotics. Conclusion: Young age, low serum albumin level, long course of diabetes, and poor hemodynamic assessment of both lower extremities are risk factors for deteriorated foot disease. Diabetic foot patients with young age, low serum albumin level and no kidney disease tend to have greater intensity of antibiotic use.

参考文献:

[1] 中国医疗保健国际交流促进会糖尿病足病分会.中国糖尿病足诊治指南[J].中华医学杂志,2017,97(4):251-258.
[2] JIANG Y,WANG X,XIA L,et al.A cohort study of diabetic patients and diabetic foot ulceration patients in China[J].Wound Repair Regen,2015,23(2):222-230.
[3] 赵静静,王伟灵,郑培莉.中国人群糖尿病足相关危险因素的Meta分析[J].检验医学,2014(6):640-645.
[4] 张艳.2型糖尿病并发糖尿病足住院患者的相关因素观察与分析[J].现代医学,2015,43(6):778-781.
[5] 王璐宁,杨彩哲,吴石白.不同溃疡程度糖尿病足患者的临床特点及预后分析[J].北京医学,2017,39(3):257-260.
[6] 王小静,吴翔,李英莎,等.糖尿病足患者细菌感染特征及其与下肢血管病变程度的关系[J].第三军医大学学报,2016,38(9):982-986.
[7] JIANG Y,RAN X,JIA L,et al. Epidemiology of type 2 diabetic foot problems and predictive factors for amputation in China[J].Int J Low Extrem Wounds,2015,14(1):19-27.
[8] 付永丽,李婧波,张宜默.糖尿病足感染病原菌耐药性及相关危险因素分析[J].中华医院感染学杂志,2013,23(15):3629-3630,3633.
[9] 关小宏,杨彩哲,吴石白.糖尿病足感染的特点与治疗[J].中华医院感染学杂志,2012,22(19):4237-4239.
[10] 王涛,曹萌,李拉克,等.糖尿病足感染多药耐药菌的分布及耐药性与危险因素分析[J].中华医院感染学杂志,2015,25(2):327-329.
[11] 周丽华,琚枫,陈显英,等.糖尿病足感染多药耐药菌的分布特点、耐药性及其危险因素分析[J].中华医院感染学杂志,2016,26(17):3953-3955.
[12] DATTA P,CHANDER J,GUPTA V,et al.Evaluation of various risk factors associated with multidrug-resistant organisms isolated from diabetic foot ulcer patients[J].J Lab Physicians,2019,11(1):58-62.
[13] 唐凤,张万会,李润.糖尿病足感染患者中血清降钙素原与血清超敏C-反应蛋白水平变化的临床评价[J].影像研究与医学应用,2018,2(3):230-231.

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