探讨糖化血红蛋白在2型糖尿病足合并感染中的价值

摘要

Objective To evaluate the value of HbA 1 c in type 2 diabetic patients with infected foot.Methods 159 type 2 diabetic patients with infected foot ulcers (Wagner' s grade 1-5) were retrospectively enrolled and divided into diabetic foot infection group (n=75) and no diabetic foot infection group (n=84),recording demographic characteristics.Results 159 type 2 diabetic patients with infected foot ulcers were analyzed,male accounting for 64.2％,the average age of (68.8 ± 11.6) years old,the average duration of diabetes of (9.6 ± 7.4) years.The level of HbA 1C was (7.0 ± 3.9)％.The duration of ulcer was (19.4 ± 15.0) days and toe lesions was commoner (45.3％),28.3％-40.3％ of ulcers were Wagner staged 1 or 2.Most of patients had diabetic complications including peripheral neuropathy (52.8％),lower extremity vascular disease (30.8％),diabetic nephropathy (20.1％).A total of 91 isolates were detected.Among them,50.5％ were gram-positive cocci,the majority were Staphylococcus aureus (28.6％); 41.8％ were gram-negative bacilli,the majority were Escherichia coli (22.0％).The duration of ulcer and the level of HbAlc in DFI group were significantly higher than those in NDFI group (P ＜ 0.01).However,age and duration of diabetes in two groups showed no significant differences (P ＞ 0.01).Conclusions Diabetic foot is the result of multiple factors.It is necessary to monitor the level of HbA I c for individualized treatment.%目的 探讨糖化血红蛋白在2型糖尿病足患者合并感染中的水平变化的意义.方法 回顾性纳入159例糖尿病足患者(Wagner分级1～5),糖尿病足感染(DFI)组(n=75),非糖尿病足感染(NDFI)组(n=84),记录上述患者临床资料.结果 159例糖尿病足患者中男性占64.2％,平均年龄(68.8±11.6)岁,平均糖尿病病程(9.6±7.4)年,HbA1C水平(7.0±3.9)％；溃疡病程(19.4± 15.0)天,溃疡部位以足趾多见(45.3％)；Wagner分级法中以1～2级最多,占28.3％ ～ 40.3％；并发症相关病变依次是周围神经病变(52.8％),下肢血管病变(30.8％),糖尿病肾病(20.1％)；共检出91株病原菌,其中革兰阳性球菌占50.5％,以金黄色葡萄球菌检出率最高为28.6％；革兰阴性杆菌占41.8％,以大肠埃希菌检出为主占22.0％；DFI组溃疡病程、HbA1c水平显著高于NDFI组(P＜0.01),而年龄、糖尿病病程在两组间差异无统计意义(P＞0.01).结论 糖尿病足是多方面因素共同作用的结果,评估DFI患者病情时,有必要监测HbA1c水平,进行个体化治疗.