本文選題：2型糖尿病 + 趾甲真菌病��； 參考：《重慶醫(yī)科大學(xué)》2013年碩士論文

【摘要】：目的：了解重慶地區(qū)2型糖尿病(T2DM)患者趾甲真菌病的患病率，并探討T2DM患者趾甲真菌病的易感因素及趾甲真菌病與糖尿病足潰瘍的關(guān)系。 方法：納入2011年7月~2013年1月于我院內(nèi)分泌內(nèi)科住院的T2DM患者374例，及300例非糖尿病受試者作為對(duì)照組（包括上述T2DM患者的配偶132例及我院體檢中心體檢的受試者168例）。收集受試者的趾甲甲屑行真菌鏡檢。采用問(wèn)卷調(diào)查、體格檢查、查閱病歷等方式收集受試者的性別、年齡、糖尿病病程、高血壓史、吸煙史、趾甲真菌病家族史、冠心病史、腦梗塞病史、體重指數(shù)、足部潰瘍、糖化血紅蛋白(HbA1c)、膽固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL-c)、低密度脂蛋白(LDL-c)、血糖、血壓、糖尿病并發(fā)癥情況、足癬等相關(guān)資料。用SPSS17.0統(tǒng)計(jì)軟件進(jìn)行分析。結(jié)果：糖尿病組與對(duì)照組平均年齡分別為62.93±11.56歲和57.76±12.51歲，兩組趾甲真菌病的患病率分別為49.5%和29.6%（P＜0.05）。年齡亞組分析顯示，當(dāng)年齡＜55歲時(shí)，兩組間趾甲真菌病的患病率差異無(wú)統(tǒng)計(jì)學(xué)意義（P＞0.05）；年齡≥55歲時(shí)，糖尿病組趾甲真菌病患病率較對(duì)照組高，差異有統(tǒng)計(jì)學(xué)意義（P＜0.05）。T2DM患者中趾甲真菌病組的年齡、糖尿病周圍神經(jīng)病變患病率、高血壓患病率、足癬患病率及趾甲真菌病家族史的陽(yáng)性率明顯高于無(wú)趾甲真菌病組(P＜0.05)。Logistic多因素回歸分析表明T2DM患者年齡增加（OR=3.373，95%CI1.698~6.703，P=0.001）、足癬（OR=2.480，95%CI1.005~6.120，P=0.049）、趾甲真菌病家族史（OR=2.643，，95%CI1.416~4.934，P=0.002）是趾甲真菌病的易感因素。T2DM患者中趾甲真菌病并未明顯增加糖尿病足潰瘍的發(fā)生風(fēng)險(xiǎn)（OR=1.027，95%CI0.617~1.708，P=0.918）。 結(jié)論：T2DM患者趾甲真菌病的患病率較非糖尿病受試者明顯增高；T2DM患者趾甲真菌病的易感因素包括年齡增加、足癬、趾甲真菌病家族史；T2DM患者趾甲真菌病與糖尿病足潰瘍發(fā)生的關(guān)系不大。
[Abstract]:Objective: to investigate the prevalence of toenail mycosis in type 2 diabetes mellitus (T2DM) in Chongqing, and to explore the risk factors of toenail mycosis and the relationship between toenail mycosis and diabetic foot ulcer. Methods: from July 2011 to January 2013, 374 patients with T2DM and 300 non-diabetic subjects were included as control group (including 132 spouses of T2DM patients and 168 subjects examined in our physical examination center). The toenails of the subjects were collected for mycological examination. Gender, age, course of diabetes, history of hypertension, history of smoking, family history of toenail mycosis, history of coronary heart disease, history of cerebral infarction, body mass index, foot ulcer were collected by questionnaire, physical examination and medical records. Glycosylated hemoglobin (HbA1c), cholesterol (TC), triglyceride (TG), high density lipoprotein (HDL-c), low density lipoprotein (LDL-c), blood glucose, blood pressure, diabetic complications, tinea pedis and so on. SPSS 17.0 statistical software was used to analyze. Results: the average age of diabetic group and control group were 62.93 鹵11.56 years old and 57.76 鹵12.51 years old respectively. The prevalence rate of toenail mycosis was 49.5% and 29.6% respectively (P < 0.05). The age subgroup analysis showed that there was no significant difference in the prevalence of toenail mycosis between the two groups when the age was less than 55 years old (P > 0.05), and the prevalence rate of toenail mycosis in diabetic group was higher than that in the control group when the age was more than 55 years old. The difference was statistically significant (P < 0.05). The age, the prevalence of diabetic peripheral neuropathy and the prevalence of hypertension in patients with toenail mycosis were significant (P < 0.05). The prevalence of tinea pedis and the positive rate of the family history of toenail mycosis were significantly higher than those of the patients without toenail mycosis (P < 0.05). Logistic multivariate regression analysis showed that the age of T2DM patients increased (OR3.37395 CI 1.6986.703 P0.001), tinea pedis (OR2.480995 CI 1.0056.120 P0.049), and the family history of toenail mycosis (OR2.64395CI1.416164.934P0. 002) were susceptible to toenail mycosis. Toenail mycosis in T2DM patients did not significantly increase the risk of diabetic foot ulcers (OR1.02795CI0.6171.708P0.918). Conclusion the prevalence of toenail mycosis in T2DM patients is significantly higher than that in non-diabetic subjects. The risk factors of toenail mycosis in T2DM patients include age, tinea pedis and family history of toenail mycosis. Toenail mycosis was not associated with diabetic foot ulcer in type 2 DM patients.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2013
【分類號(hào)】：R587.2;R519

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