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慢性病患者的下肢截肢率:一个数据库研究,比较患有和没有糖尿病的患者
Dhruv Nandakumar1, Matthew J Johnson2, Lawrence A Lavery2
1University of Texas Southwestern Medical School, Dallas, TX, USA.
Journal of diabetes and its complications
|October 8, 2024
概括
糖尿病 (DM) 在所有慢性病 (CKD) 阶段显著增加下肢截肢 (LEA) 风险. 患有DM和晚期CKD的患者面临着LEA的可能性大幅增加.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 内分泌学 在内分泌学.
- 血管外科 血管外科
背景情况:
- 下肢截肢 (LEA) 是糖尿病 (DM) 的严重并发症.
- 关于DM和慢性病 (CKD) 与LEA风险之间的相互作用尚未完全理解.
研究的目的:
- 评估DM对CKD所有五个阶段的LEA利率的影响.
- 为了比较不同CKD阶段的DM和无DM患者的LEA发病率.
主要方法:
- 使用了非识别的商业数据库 (2010-2023年),包括接受LEA和CKD患者的患者.
- 包括患有DM和没有DM的患者,跟踪至少5年.
- 根据糖尿病状况分层的CKD各个阶段 (1-5) 的LEA比较率.
主要成果:
- 与没有DM的患者相比,在所有CKD阶段,DM患者的LEA率 (整体,轻微,主要) 显着更高.
- 患有5期CKD的DM患者的整体LEA (OR 30.2) 的可能性增加了30倍,而非DM的CKD5期患者则增加了30倍.
- 在DM患者中,LEA的发病率随着CKD从第二到第五阶段的进展显著增加,在第四到第五阶段之间显著增加.
结论:
- 伴随性糖尿病在CKD的每个阶段都会显著提高LEA风险.
- DM和高级CKD (5阶段) 的组合对LEA具有极高的风险.
- 慢性瘤的进展是糖尿病患者中LEA的重要危险因素,特别是在2期以后.
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