在有糖尿病足病史的患者中,微循环参数受损
Julien Vouillarmet1, Audrey Josset-Lamaugarny2,3, Myriam Moret4
1Service d'Endocrinologie, Diabète et Nutrition, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, 69310 Pierre Bénite, France.
Medicina (Kaunas, Lithuania)
|January 25, 2025
概括
通过评估视网膜病变和运动功能,可以改善糖尿病足 (DFU) 风险分类. 患有DFU (3级) 病史的患者表现出更多的视网膜病变和改变的运动功能,这表明这些因素改进了DFU风险评估.
科学领域:
- 糖尿病学 糖尿病学
- 血管医学 血管医学
- 神经学 神经学
背景情况:
- 糖尿病足 (DFU) 具有显著的风险,在患有先前的DFU (3级) 的患者中发生率较高,而不是仅患有外围神经病变 (1-2级) 的患者.
- 假设微循环障碍有助于DFU的发展,并可能完善现有的风险分层.
- 目前国际糖尿病脚工作组 (IWGDF) 的分类可能会从纳入微血管参数中受益.
研究的目的:
- 为了评估糖尿病患者的微循环参数,根据DFU风险分层.
- 为了比较IWGDF 1-2级和3级患者之间的微循环,神经病变和运动功能.
- 确定微血管和相关参数是否可以增强DFU风险评估.
主要方法:
- 172名患有神经病变和/或DFU病史的2型糖尿病患者根据IWGDF标准被分为1-2级或3级.
- 评估包括对外围神经病变的评估,足部运动功能测试和皮肤微循环参数测量.
- 在两个风险组之间进行了统计比较.
主要成果:
- 两组之间没有观察到年龄,糖尿病持续时间,透皮氧气压,皮肤微循环反应能力,神经病症得分或热敏度的显著差异.
- 3级患者表现出视网膜病变 (OR 3.15) 和严重的运动功能障碍 (OR 2.73) 的更高患病率.
- 3级患者不太可能有异常的振动感知值 (VPT) (或0.20).
结论:
- 与1-2级相比,被归类为3级 (DFU病史) 的糖尿病患者表现出视网膜病变的增加和更严重的运动功能障碍.
- 这些发现表明,视网膜病变和运动功能的改变是有价值的指标.
- 纳入这些参数可以改善对糖尿病足的高风险个体的识别.
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