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| DOI： |
| 中文关键词: 难愈性糖尿病足溃疡 危险因素 预测模型 |
| 英文关键词:Refractory diabetic foot ulcer, risk factors, predictive model |
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| 摘要点击次数: 307 |
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| 中文摘要: |
| 目的 探讨难愈性糖尿病足溃疡发生的危险因素并构建预测模型。方法 回顾性分析2022年1月~2024年1月于济南市市中区人民医院治疗的140例糖尿病足溃疡患者的临床资料,根据治疗4周后溃疡的进展情况将患者分为难愈组和对照组,对比分析两组患者的性别、年龄、糖尿病病程等临床资料,进行单因素分析,组间比较有显著差异的单因素,代入二元Logistic回归分析进行独立危险因素检验,筛选难愈性糖尿病足溃疡发生的危险因素,建立预测模型并绘制列线图,绘制模型的校准曲线并计算一致性指数、绘制受试者工作特征曲线和临床决策曲线验证预测模型的准确性。结果 两组患者血运重建手术史、冠心病、对侧肢体缺失情况、文化程度、踝肱指数、Wagner分级、合并骨髓炎人数、超敏C反应蛋白、糖化血红蛋白、肌酐、降钙素水平差异有显著统计学意义(P＜0.05)；Logistic回归显示,文化程度、踝肱指数、超敏C反应蛋白、降钙素水平是形成难愈性糖尿病足溃疡的独立危险因素。构建预测模型,绘制列线图并制得评分系统,评分系统的一致性指数为0.871,受试者工作特征曲线下面积为0.831。结论 文化程度、踝肱指数、超敏C反应蛋白、降钙素水平是形成难愈性糖尿病足溃疡的独立危险因素,可作为评估糖尿病足溃疡严重程度的指标,本研究构建的预测模型准确性较高,可用于预测难愈性糖尿病足溃疡的发生几率。 |
| 英文摘要: |
| Objective To investigate the risk factors of refractory diabetic foot ulcer and establish the predictive model. Methods The clinical data of 140 diabetic foot ulcer patients received treatment in the People’s Hospital of Jinan Shizhong District during Jan 2022 to Jan 2024 were retrospectively analyzed. The patients were divided into refractory group and control group according to the ulcer progression after 4 weeks treatment. The clinical data of the two groups, such as gender, age, duration of diabetes, were compared and analyzed in a single-factor analysis. The single factors with significant differences between two groups were substituted into binary logistic regression analysis for independent risk factor test. Predictive model was established and the nomogram was drawn to predict the occurrence of refractory diabetic foot ulcer. The calibration curve, concordance index, receiver operating characteristic curve and decision curve analysis were drawn to further verify the accuracy of the prediction model. Results History of revascularization surgery, coronary artery disease, contralateral limb loss, education level, ankle-brachial index, Wagner classification, number of combined osteomyelitis, hyper-sensitive C-reactive protein, glycosylated hemoglobin, creatinine, and procalcitonin levels in both groups were statistically significant differences(P<0.05). Logistic regression showed that education level, ankle-brachial index, hyper-sensitive C-reactive protein and procalcitonin levels in both groups were the independent risk factors of occurrence of refractory diabetic foot ulcer. The predictive model nomogram was constructed, and the scoring system was further developed. The concordance index of this predictive model was 0.871, the area under the receiver operating characteristic curve was 0.831. Conclusion Education level, ankle-brachial index, hyper-sensitive C-reactive protein and procalcitonin levels in both groups were the independent risk factors of occurrence of refractory diabetic foot ulcer, which can be used as an indicator to assess the severity of diabetic foot ulcer. The predictive model established in this study has high accuracy, which can be used to predict the incidence of refractory diabetic foot ulcer. |
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