中国骨伤2025，Vol.38Issue(9)：884-890,7.DOI:10.12200/j.issn.1003-0034.20250032
糖尿病足湿性与干性坏疽临床特征相关性分析
Correlation analysis of clinical features between wet and dry gangrene in diabetic foot
摘要
Abstract
Objective To explore clinical characteristics,lesion sites and correlation differences of different types of dia-betic foot gangrene,and to provide evidence-based basis for clinical classification of diabetic foot gangrene.Methods A retro-spective analysis was conducted on 266 patients with newly diagnosed diabetic foot gangrene who were admitted from January 2018 to December 2018,including 183 males and 83 females,aged from 35 to 92 years old with an average of(69.55±10.84)years old,and they were divided into wet gangrene group and dry gangrene group according to the different natures of gangrene.There were 139 patients in wet gangrene group,including 98 males and 41 females,aged from 35 to 90 years old with an aver-age of(68.95±10.93)years old.There were 127 patients in dry gangrene group,including 85 males and 42 females,aged from 38 to 92 years old with an average of(70.21±10.75)years old.Body mass index(BMI),waist-to-hip ratio(WHR),body tem-perature,skin temperature difference between the affected and healthy sides of the lower extremities,and Wagner grade be-tween two groups were recorded to evaluate symptoms and signs.The white blood cell count(WBC),neutrophil percentage(NEUT％),and C-reactive protein(C-reactive protein),erythrocyte sedimentation rate(ESR),procalcitonin(PCT),and in-terleukin-6(IL-6)in peripheral blood between two groups were detected and compared to evaluate the infection status;the severity of diabetic peripheral neuropathy(DPN)was evaluated by using Toronto Clinical Scoring System(TCSS);the degree of pain in patients with diabetic foot gangrene was evaluated by numerical rating scale(NRS);ankle-brachial index(ABI)and popliteal artery blood flow velocity were used to evaluate the degree of arterial lesions.Spearman correlation analysis was used to analyze the correlations between gangrene TCSS,ABI and age,BMI,WHR,body temperature,calf skin temperature difference,WBC,NEUT％,CRP,ESR,PCT,IL-6,NRS,and Wagner classification indicators.Results The body temperature,skin temperature difference between the affected and healthy sides of the lower extremities,Wagner grade,WBC,NEUT％,CRP,ESR,PCT,IL-6,TCSS score,ABI,and popliteal artery blood flow velocity in wet gangrene group were higher than those in dry gangrene group(P＜0.01),and BMI,WHR,and NRS score in dry gangrene group were higher than those in wet gangrene group;the differences were all statistically significant(P＜0.01).The results of Spearman correlation analysis showed TCSS score of gangrene patients was correlated with body temperature(r=0.214),calf skin temperature difference(r=0.364),WBC(r=0.240),NEUT％(r=0.291),CRP(r=0.347),ESR(r=0.167),PCT(r=0.241),IL-6(r=0.316),and popliteal fossa arterial blood flow velocity(r=0.261)and Wagner grade(r=0.273)were positively correlated,and the differences were statistically significant(P＜0.01).ABI was negatively correlated with age(r=-0.183),BMI(r=-0.252),WHR(r=-0.288),and NRS score(r=-0.354),and the differences were statistically significant(P＜0.01).Conclusion Diabetic foot gangrene is an extremely dif-ficult and critical disease.Wet gangrene has a significant synergic effect with infection and neuropathy,while dry gangrene is closely related to vascular occlusion.The main contradiction of gangrene could be revealed through blood vessels,nerves and infection,providing evidence-based basis for the selection of debridement timing,anti-infection strategies and revasculariza-tion,with the aim of reducing the risk of amputation.关键词
糖尿病足坏疽/干性坏疽/湿性坏疽/临床特征/相关性研究Key words
Diabetic foot gangrene/Dry gangrene/Wet gangrene/Clinical features/Correlation studies分类
医药卫生引用本文复制引用
王御震,贾成林,张永康,邓俊林,戴宗昊,赵诚,曹烨民..糖尿病足湿性与干性坏疽临床特征相关性分析[J].中国骨伤,2025,38(9):884-890,7.基金项目
国家自然科学基金项目面上项目(编号:82174382) （编号:82174382）
全国基层名老中医药专家曹烨民传承工作室建设项目(编号:Z155080000004) （编号:Z155080000004）
上海市名老中医学术经验研究工作室建设项目(编号:SHGZS-202248) （编号:SHGZS-202248）
上海市卫生健康委员会卫生行业临床研究专项(编号:20224Y0387) （编号:20224Y0387）
上海市中西医结合医院青年人才培养计划(编号:RCPY0056)General Program of National Natural Science Foundation of China(No.82174382) （编号:RCPY0056）
