2型糖尿病患者自然步态下赤足足底压力特征分析

摘要

Objective To explore the characteristics of foot plantar pressure (FPP) in patients with type 2 diabetes mellitus (T2DM). Methods With a RS-SCAN Footscan 1 m plate pressure measurement system, FPP without shoes of 357 patients were measured for three times and the average FPP were calculated according to multi-measurements. The foot was divided into ten areas, that is, toe 1 (T1), toe 2-5 (T2-5), metatarsal 1 to metatarsal 5(M1, M2, M3, M4, M5), middle foot (MF), heel medial (HM) and heel lateral (HL), respectively. Meanwhile, the appearance of the foot was checked to conform if there were calluses or hallux valgus. Patients were divided into flat foot group, talipes cavus group and normal group according to arch index. FPP of ten areas, whole FPP and average FPP (N/cm2) were analyzed and whole FPP between left and right foot, between male and female patients were also compared. Average FPP among patients with different foot appearance and those with different foot types were compared as well. Results The highest area of FPP was M3, followed by M4, M2 on left foot and M3, M2, HM in turn on right foot. Whole FPP of left foot was significantly higher than that of right foot among all patients (P<0.01), and FPP of male patients was higher than that of female patients (P<0.05). Of 357 patients, 66 had callus on left or right foot, 45 hallux valgus and the average FPP was highest in patients with callus compared with other two groups (P<0.05). The average FPP did not differ significantly among flat foot group, talipes cavus group and normal group (P>0.05). Conclusion The highest FPP is located in metatarsal 3 and whole FFP of left foot is higher than that of right foot. FPP of male patients is higher than that of female and average FFP patients with callus reaches the highest.%　　目的探讨2型糖尿病患者足底压力分布特点.方法使用比利时RS-SCAN公司生产的Footscan1m压力平板,检测357例2型糖尿病患者自然行走过程的赤足压力,多次测量后取3次数据计算各区域压强的平均值录入 SPSS 16.0统计软件.结合足底压力测量软件将足底分为第1趾,第2—第5趾、第1、第2、第3、第4、第5跖骨底、足弓、足跟内侧、足跟外侧共10个解剖区域.检查足外观有无胼胝及拇趾外翻,根据软件计算足弓指数将患者足型分为正常足、扁平足及高弓足,分析指标为患者足底各分区压强、全足压强和双足平均总压强(N/cm2),比较左右足全足压强及不同性别患者左右足全足压强,不同足外观、足型患者双足平均总压强.结果足底各分区前3位排序,左足：第3跖骨底>第4跖骨底>第2跖骨底,右足第3跖骨底>第2跖骨底>足跟内侧.左、右足全足压强比较差异有统计学意义,左足>右足(P<0.01),男性患者左右足全足压强均大于女性患者(P<0.05).357例患者中胼胝者66例,拇趾外翻45例.比较不同足外观患者双足平均总压强,胼胝组最高(P<0.05).不同足型患者比较,3组间足底压强差异无统计意义(P>0.05).结论2型糖尿病患者足底各分区压强最高值双足均为第3跖骨底,全足总压强比较左足>右足,男性>女性.糖尿病合并胼胝者足底压强最高,不同足型患者间足底压强差别无统计学意义.