【摘要】 目的探讨糖尿病足（DF）患者的截肢率、生存率,寻找影响该类患者小截肢、大截肢、死亡的独立危险因素。方法选取2014年1月至2016年1月于重庆医科大学附属第一医院收治的273例DF患者住院资料,采用电话随访的形式对患者随访至2016年12月。应用聚类分析筛选变量,KaplanMeier计算生存率、截肢率的差异,Cox比例风险模型分析小截肢、大截肢、死亡的危险因素。结果 DF患者1年生存率88.3%,1年截肢率13.4%。溃疡严重情况（HR=3.332）、HbA₁c（HR=1.391）、LDL-C（HR=1.173）、Scr（HR=1.003）、白细胞总数（HR=1.085）为DF患者小截肢的独立危险因素（P<0.05）;载脂蛋白A1（HR=0.071）为DF患者大截肢的独立危险因素（P<0.05）;溃疡严重情况（HR=3.166）、冠心病（HR=4.168）、截肢史（HR=3.567）、血红蛋白（HR=0.966）为DF患者死亡的独立危险因素（P<0.05）。结论 DF患者疾病预后是多因素的综合作用,与溃疡严重情况、营养状况、炎症因素、肾功能、截肢史,以及冠心病等密切相关。更多还原

【Abstract】 Objective To evaluate the prevalence of lower extremity amputation and morality in patients with diabetic foot and to explore the influencing factors for minor amputation,major amputation and death. Methods A total of 273 hospitalized patients with diabetic foot in the First Hospital of Chong Qing Medical University from January 2014 to January 2016 were enrolled in this study and followed up until December 2016.Variables were selected by clustering analysis.Survival rate and amputation rate were derived from Kaplan-Meier curves.The risk factors for minor amputation,major amputation and death were evaluated by Cox proportional hazard model. Results The one-year survival rate was 88.3%,one-year amputation rate was 13.4%.The ulceration severity（HR = 3.332）,glycosylated hemoglobin A1c（HbA₁c）（HR=1.391）low density lipoprotein cholesterin（LDL-C）（HR=1.173）,white blood cell count（WBC count）（HR=1.085）,and serum creatinine（Scr）（HR=1.003）were found to be independent prognostic factors for minor amputation（P<0.05）.The Apolipoprotein A1（ApoA1）（HR=0.071）was found to be independent prognostic factor for major amputation（P<0.05）.The ulceration severity（HR=3.166）,coronary heart disease（CHD）（HR=4.168）,amputation（HR=3.567）and hemoglobin（HR=0.966）were found to be independent prognostic factors for the mortality.Conclusion Multi-factors showed a positive correlation with the prognosis of diabetic foot.Ulceration severity,nutrition,inflammation,renal function,amputation and coronary heart disease were closely related with diabetic foot prognosis.更多还原