与糖尿病神经病变和神经病变相关的主要不良脚事件和功能性运动缺陷
David R Sinacore1, Michael A Jones2, Paul W Kline1
1Department of Physical Therapy, High Point University, High Point, NC 27268, USA.
Metabolism and target organ damage
|June 3, 2024
概括
在患有慢性病的糖尿病外围神经病患者中,主要的不良脚事件和运动缺陷很常见. 截肢和移动问题的风险从CKD第3阶段开始增加.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 内分泌学 在内分泌学.
- 足部医学是一门专业.
背景情况:
- 糖尿病周围神经病变 (DPN) 是糖尿病的常见并发症,增加了脚部并发症的风险.
- 慢性病 (CKD) 也在糖尿病患者中很普遍,可能会加剧与DPN相关的问题.
- DPN,CKD阶段和足部健康结果之间的相互作用需要进一步研究.
研究的目的:
- 为了确定各个CKD阶段的DPN患者主要不良脚事件 (MAFEs) 的风险比率 (RR).
- 评估DPN患者中度和严重的功能性移动性缺陷的RR,跨越CKD阶段.
- 分析MAFE患病率与跨CKD阶段的功能性移动性之间的关联.
主要方法:
- 对284名患有糖尿病,DPN和CKD的参与者的回顾性研究.
- 从足部X射线报告中发现的MAFE (骨折,,Charcot关节病,骨髓炎,截肢).
- 使用修改物理性能测试 (mPPT) 评估的功能移动性;定义了中度 (22-29) 和严重 (<22) 的缺陷.
- 未调整和调整的RR计算在CKD阶段,以1阶段为参考.
主要成果:
- 脚骨折,Charcot关节病和的RR在CKD各个阶段保持一致.
- 轻微截肢的RR在CKD第4和第5阶段增加.
- 中度/重度移动性缺陷的RR在CKD第3,4和第5阶段增加.
- 在CKD各个阶段的MAFE流行率和mPPT得分之间观察到逆相关性.
结论:
- 在患有糖尿病病的DPN患者中,MAFE和功能性移动性缺陷很普遍.
- 轻微截肢和运动缺陷的风险早在CKD第3阶段就会升级.
- 这些风险在晚期CKD阶段 (4和5) 进一步增加,突出了需要主动管理的需要.
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