中国部分省市糖尿病足病临床资料和住院费用等比较
중국부분성시당뇨병족병림상자료화주원비용등비교
Comparison of clinical characteristics and medical costs of patients with diabetic foot ulcer in some provinces of China
  • 万方数据
    中华糖尿病杂志 중화당뇨병잡지
    CHINES JOURNAL OF DLABETES MELLITUS
    2014年 7期 499-503 ,共5页

    班绎娟%冉兴无%杨川%王鹏华%马建华%陈兵%于艳梅%冯波%陈莉丽%殷汉%成志峰%贾黎静%闫朝丽%杨玉芝%刘芳%杜玉茗%毛季萍%肖正华%林少达%赵湜%马学毅%周迎生%陈国昌%卞茸文%许樟荣

    반역연%염흥무%양천%왕붕화%마건화%진병%우염매%풍파%진리려%은한%성지봉%가려정%염조려%양옥지%류방%두옥명%모계평%초정화%림소체%조식%마학의%주영생%진국창%변용문%허장영

    糖尿病%糖尿病足%截肢%住院费用 糖尿病%糖尿病足%截肢%住院費用
    당뇨병%당뇨병족%절지%주원비용
    Diabetes%Diabetic foot%Amputation%Hospitalization expenses
    目的比较2004年和2012年的糖尿病足病患者的临床资料、溃疡特点、预后及住院费用。方法以统一的方法调查2004年全国10个省市14家三甲医院和2012年全国11个省市15家三甲医院住院糖尿病足病患者，包括病史、生化检查、足溃疡分类分期和预后及住院费用等。采用t检验、χ2检验和u检验比较两组有关数据，住院费用进行消费价格指数校正。结果2004、2012年糖尿病足病患者分别为386例、682例。2012年与2004年相比，患者的年龄、文化程度、糖尿病病程、腰臀比、糖化血红蛋白、甘油三酯、高密度脂蛋白胆固醇、尿酸、血脂异常的检出率、脑血管病和外周动脉病变及糖尿病周围神经病变的患病率、溃疡性质及住院费用的差异均无统计学意义（均P＞0.05）。与2004年相比，2012年患者的足病病程短[1（1～6）比6（1～16）月，u＝-7.955，P＜0.05]、男性比例高（65.2％比58.5％，χ2＝4.738，P＜0.05）；吸烟率（45.8％比39.0％，χ2＝4.602，P＜0.05）、饮酒率（41.1％比19.1％，χ2＝51.179，P＜0.05）高；空腹血糖、餐后血糖、总胆固醇及低密度脂蛋白胆固醇降低（ t＝-2.987、-2.855、-4.91、-3.748；均P＜0.05）；高血压、冠心病、糖尿病肾病、糖尿病视网膜病变的患病率升高（χ2＝47.572、13.297、9.638、4.329；均P＜0.05）；足溃疡的感染率、Wagner 3级以上比例及Texas D期比例升高（χ2＝6.787、40.880、11.028，均P＜0.05）；总截肢率升高，但大截肢率降低、愈合率升高（χ2＝8.838、8.908、107.773，均P＜0.05），住院天数缩短[18（12～32）比21（15～32）d，u＝-3.349，P＜0.05]。结论2012年与2004年的糖尿病足病患者具有高龄、男性居多、文化程度低、糖尿病病程长、血糖控制差、心血管危险因素及糖尿病并发症多、住院费用高的特点。2012年与2004年相比，糖尿病足病患者合并症及并发症更多、足溃疡更严重、总截肢率更高，但大截肢率降低、愈合率升高、住院天数缩短。
    목적비교2004년화2012년적당뇨병족병환자적림상자료、궤양특점、예후급주원비용。방법이통일적방법조사2004년전국10개성시14가삼갑의원화2012년전국11개성시15가삼갑의원주원당뇨병족병환자，포괄병사、생화검사、족궤양분류분기화예후급주원비용등。채용t검험、χ2검험화u검험비교량조유관수거，주원비용진행소비개격지수교정。결과2004、2012년당뇨병족병환자분별위386례、682례。2012년여2004년상비，환자적년령、문화정도、당뇨병병정、요둔비、당화혈홍단백、감유삼지、고밀도지단백담고순、뇨산、혈지이상적검출솔、뇌혈관병화외주동맥병변급당뇨병주위신경병변적환병솔、궤양성질급주원비용적차이균무통계학의의（균P＞0.05）。여2004년상비，2012년환자적족병병정단[1（1～6）비6（1～16）월，u＝-7.955，P＜0.05]、남성비례고（65.2％비58.5％，χ2＝4.738，P＜0.05）；흡연솔（45.8％비39.0％，χ2＝4.602，P＜0.05）、음주솔（41.1％비19.1％，χ2＝51.179，P＜0.05）고；공복혈당、찬후혈당、총담고순급저밀도지단백담고순강저（ t＝-2.987、-2.855、-4.91、-3.748；균P＜0.05）；고혈압、관심병、당뇨병신병、당뇨병시망막병변적환병솔승고（χ2＝47.572、13.297、9.638、4.329；균P＜0.05）；족궤양적감염솔、Wagner 3급이상비례급Texas D기비례승고（χ2＝6.787、40.880、11.028，균P＜0.05）；총절지솔승고，단대절지솔강저、유합솔승고（χ2＝8.838、8.908、107.773，균P＜0.05），주원천수축단[18（12～32）비21（15～32）d，u＝-3.349，P＜0.05]。결론2012년여2004년적당뇨병족병환자구유고령、남성거다、문화정도저、당뇨병병정장、혈당공제차、심혈관위험인소급당뇨병병발증다、주원비용고적특점。2012년여2004년상비，당뇨병족병환자합병증급병발증경다、족궤양경엄중、총절지솔경고，단대절지솔강저、유합솔승고、주원천수축단。
    Objective To compare and analyze clinical data , ulcer characteristics , prognosis and hospitalization expenses in the patients with diabetic foot ulcer in 2004 and 2012 in China.Methods Diabetic foot disease data from 14 great three A hospitals from 10 provinces or cities in 2004 and 15 great three A hospitals from 11 provinces or cities in 2012 in China were collected and analyzed , including the medical history , physical and biochemical examinations , demographic characteristics , prognosis and hospitalization expenses.The classification , stage and risk factors of diabetic foot ulcer were also compared between two groups.The t, χ2 and u tests were used for comparing between two groups of data.Hospitalization expenses of diabetic foot disease was corrected with consumer price index .Results 386 cases in 2004 and 682 cases in 2012 were recruited.No significant differences in age , educational level , duration of diabetes , waist hip ratio, glycosylated hemoglobin A1c, triglyceride, high density lipoprotein cholesterol, uric acid, prevalence of dyslipidemia, cerebrovascular, peripheral artery disease, diabetic peripheral neuropathy , ischemic foot ulcer , and hospitalization expenses between two groups ( all P >0.05).Compared with the patients in 2004, duration of diabetic foot (1(1-6) vs 6(1-16) m,u=-7.955, P<0.05) was shorter, more men(65.2%vs 58.5%,χ2 =4.738,P<0.05), more patients with smoking (45.8%vs 39.0%,χ2 =4.602,P<0.05) and/or drinking(41.1% vs 19.1%,χ2 =51.179,P<0.05), lower fasting and postprandial blood glucose , total cholesterol and low density lipoprotein cholesterol in 2012 (t=-2.987,-2.855,-4.910,-3.748,all P<0.05).The higher prevalence of hypertension , coronary heart disease, diabetic kidney disease, diabetic retinopathy (χ2 =47.572,13.297,9.638,4.329;all P<0.05), and more patients with infectious foot ulcer , more patients with severe foot disease whose foot ulcer classified as Wagner 3 and above or Texas D (χ2 =6.787,40.880,11.028,all P<0.05).There were significantly lower major amputation rate , higher ulcer healing rate (χ2 =8.838, 8.908, 107.773, all P<0.05), shorter hospital stay (18(12-32) vs 21(15-32)d, u=-3.349, P<0.05).Conclusions The patients with diabetic foot disease in 2004 and 2012 were older, with more men, low educational level , long duration of diabetes , poor control of hyperglycemia , high hospitalization expenses and with more cardiovascular risk factors and diabetic complications.Compared with the patients in 2004, patients with diabetic foot disease in 2012 had more concomitant diseases and complications , with more severe foot ulcers and infections , higher total amputation rate , but lower major amputation rate , higher ulcer healing rate , and shorter hospital stay.
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