Analysis of Clinical Characteristics of Different Degrees of Infection in Patients with Diabetic Foot Disease
LI Lin-lin,HUO Lei,LI Pin-chuan
Department of Chinese Medicine Surgery, the Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300150, China
Abstract:
Objective To retrospectively analyze the clinical characteristics of diabetic foot disease patients with different degrees of infection and risk factors of severe infection, and then provide countermeasures for clinical prevention and treatment of diabetic foot disease. Methods The clinical data of newly diagnosed diabetic foot patients hospitalized in our department from Jan. 1, 2017 to Dec. 31, 2018 were collected. According to the Wagner classification, the patients of Wagner classification 2–3 were defined as mild infection and the patients of Wagner classification 4–5 were defined as severe infection. The differences of clinical data between the two groups were compared and the independent risk factors of severe infection in diabetic foot patients were analyzed. Results The duration of diabetes mellitus and diabetic foot in severe infection group [(19.12 ±3.12)y, (58.48 ±4.93) d] was significantly longer than that in mild infection group [(15.56 ±2.94) y, (41.37±5.87)d, P < 0.05]. The proportions of patients with diabetic retinopathy, diabetic nephropathy, hypertension, coronary heart disease and chronic heart failure (74.05%, 58.02%, 73.28%, 93.89%, 94.66%, 67.94%) in severe infection group were higher than those in mild infection group (44.09%, 37.80%, 61.42%, 72.44%, 93.70%, 52.76%).The difference was statistically significant (P<0.05).In terms of infection indicators, the white blood cellcount, percentage of neutrophils, C-reactive protein,procalcitonin, transferrin [(12.35±2.03)×109 ,(83.21±7.31)%, (96.28±21.04) mg/L, (1.56±0.42) ng/mL, (387.16±49.27) g/L] in severe infection group were significantly higher than those in mild infection group [(6.78±1.56)×109, (68.58 ±5.36)%, (38.76±11.68) mg/L, (0.97±0.12) ng/mL, (235.87±37.29) g/L, P<0.05]. The differences were statistically signi?cant. In terms of physical and chemical indexes, the erythrocyte count, hemoglobin, glycosylated hemoglobin, total protein (TP), albumin (ALB), high density lipoprotein (HDL-C), uric acid (UA), ankle-brachial index (ABI) in severe infection group were signi?cantly different from those in mild infection group (P < 0.05). Multivariate logistic regression analysis showed that the time of diabetic foot disease, diabetic nephropathy, hypoproteinemia (< 30 g/L), hyperglycated hemoglobin (>7.5%), and low ABI (<0.6) were independent risk factors for severe infection in diabetic foot patients (P<0.05). Conclusion The time of diabetic foot disease, diabetic nephropathy, hypoproteinemia, hyperglycated hemoglobin, and low ABI were independent risk factors for severe infection in diabetic foot patients.
