【摘要】：目的:分析性激素指標在不同病情糖尿病足潰瘍患者體內(nèi)的變化,探討這些變化對糖尿病足潰瘍患者預(yù)后的影響。方法:收集我院住院治療的糖尿病足潰瘍患者362例(男204例,女158例),另選取年齡匹配的高危糖尿病足病患者225例(男63例,女162例)作為對照。入院48小時內(nèi)測定入選者血漿黃體生成素、卵泡刺激素、催乳素、睪酮、游離睪酮、雄烯二酮(女性)、硫酸脫氫表雄酮(女性)、孕酮、雌二醇、性激素結(jié)合球蛋白水平,分析上述指標與糖尿病足病嚴重程度(Wagner級別)、感染程度的關(guān)系;隨訪足潰瘍患者入選后6個月潰瘍愈合、復(fù)發(fā)、患者心腦血管事件發(fā)生和死亡情況,分析性激素指標對糖尿病足潰瘍患者預(yù)后的影響。結(jié)果:隨Wagner級別上升,男性患者睪酮、游離睪酮呈下降趨勢(趨勢P值分別為0.005,0.0027),雌二醇呈升高趨勢(趨勢P值0.0012);絕經(jīng)后女性睪酮、游離睪酮、雌二醇水平呈上升趨勢(趨勢P值分別為0.041、0.035、0.0001)。隨足潰瘍感染加重,男性游離睪酮下降(趨勢P值為0.007);絕經(jīng)后女性雌二醇升高(趨勢P值為0.02)。雌二醇水平與男性和絕經(jīng)后女性糖尿病足潰瘍患者心腦血管事件的發(fā)生正相關(guān)(男性O(shè)R=1.11,P=0.03,絕經(jīng)后女性O(shè)R=1.019,P=0.03),男性雌二醇水平與死亡呈正相關(guān)(OR=1.01,P=0.04)。結(jié)論:雌二醇、睪酮在不同Wagner級別和感染程度的糖尿病足病患者體內(nèi)發(fā)生改變,雌二醇水平對患者預(yù)后有一定提示意義。
[Abstract]:Aim: to analyze the changes of sex hormone indexes in patients with diabetic foot ulcers and to explore the influence of these changes on the prognosis of diabetic foot ulcers. Methods: 362 diabetic foot ulcers (204 males and 158 females) and 225 age-matched high risk diabetic foot ulcers (63 males and 162 females) were selected as control group. Plasma luteinizing hormone, follicle stimulating hormone, prolactin, testosterone, free testosterone, androstenedione (female), dehydroepiandrosterone sulfate (female), progesterone, estradiol, androgen binding globulin were measured within 48 hours after admission. To analyze the relationship between the above indexes and the severity of diabetic foot disease (Wagner grade) and the degree of infection. Patients with foot ulcers were followed up 6 months after the ulcer healing, recurrence, cardiovascular and cerebrovascular events and death, analysis of sex hormone indicators on the prognosis of diabetic foot ulcers. Results: with the increase of Wagner grade, testosterone and free testosterone in male patients showed a downward trend (P = 0.005 鹵0.0027) and estradiol increased (P value 0.0012). The levels of testosterone, free testosterone and estradiol in postmenopausal women showed an increasing trend (P = 0.041 0. 035 鹵0. 0001). Free testosterone decreased (trend P = 0.007) and estradiol increased in postmenopausal women (trend P = 0. 02). Estradiol levels were positively correlated with cardiovascular and cerebrovascular events in male and postmenopausal women with diabetic foot ulcers (OR=1.019,P=0.03 in male OR=1.019,P=0.03 postmenopausal women). The level of estradiol was positively correlated with death (OR=1.01,P=0.04). Conclusion: the changes of estradiol and testosterone in patients with diabetic foot disease with different Wagner grade and degree of infection may indicate the prognostic significance of estradiol level.
【學(xué)位授予單位】：上海交通大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R587.2

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