ABSTRACT
Objective To explore high-risk factors that affect the severity of diabetic foot ulcers and the relationship between the severity of diabetic foot ulcers and the general somatic conditions by analyzing clinical data of 218 diabetic foot patients.Methods A retrospective analysis of the clinical data of 218 diabetic foot patients,admitted from 2006 to 2010 was performed.Fasting and postprandial blood glucose ( FBG and PBG ),glycosylated hemoglobin,hemoglobin,serum albumin,serum creatinine,as well as serum urea nitrogen and fibrinogen were determined in patients with different Wagner levels.The effects of peripheral arterial disease,neuropathy,infections and other factors on severity of diabetic foot ulcers,and the prognosis of those patients with different Wagner levels were analyzed.Results ( 1 ) FBG and PBG in Wagner 5 patients were significantly higher than those in Wagner 1,but there was no statistical significance in HbA1C difference.(2) Hemoglobin,total cholesterol,serum albumin in Wagner 5 patients were decreased significantly ; white blood cells,serum creatinine and fibrinogen were increased significantly ( P＜0.01 ).(3) The intima-media thickness(IMT) of femoral artery in Wagner 2-and-above patients was increased significantly compared with that in Wagner 1 ( P＜0.05 ).( 4 ) Logistic regression analysis showed that hemoglobin,fibrinogen,glycated hemoglobin,femoral artery intima-media thickness,and bacterial infection were correlated independently with the severity of diabetic foot ulcers.(5) The hospitalized days were increased with rising Wagner levels ; the prognosis of Wagner 5 patients was the worst,with the highest mortality in the group.Conclusions Changes in blood level of hemoglobin,fibrinogen,along with higher HbA1C and femoral artery IMT,as well as infections are high-risk factors of severity in diabetic foot patients.HbA1C is not a good indicator of blood glucose control in patients with Wagner 5 grade.The higher the Wagner grade,the longer the time spent in hospital,and the worse the prognosis wouldbe.