| Diabetic foot is a serious complication of diabetes mellitus,and its etiology is closely related to lower extremity vascular disease.The treatment process of diabetic foot is complex,the treatment duration is long,the ulcer wound healing is difficult,and in severe cases,it can lead to amputation or even death.Especially in elderly patients with diabetic foot,immunity is low,body function is reduced,and there are many underlying diseases,which makes the condition more complicated and more difficult to treat.This study aims to analyze the related factors of different prognosis,To investigate the predictive value of lower extremity vascular ultrasound combined with C-reactive protein for the prognosis of elderly patients with diabetic foot.A total of 134 patients with diabetic foot over 60 years old who were hospitalized in the Department of Endocrinology of our hospital were selected as the research objects for retrospective analysis.According to the prognosis of patients after standardized treatment by doctors,they were divided into effective treatment group(n=97)and ineffective treatment group(n=37).The basic data,laboratory indexes and ultrasound indexes of the two groups were collected and analyzed.The basic data included gender,age,body mass index,diabetes duration,history of hypertension,hyperlipidemia,and Wagner grade.Laboratory parameters included hemoglobin,C-reactive protein,erythrocyte sedimentation rate,glycosylated hemoglobin,fasting blood glucose,urea nitrogen,creatinine,total cholesterol,triglyceride,alanine aminotransferase,aspartate aminotransferase,and albumin.Ultrasound indicators included bilateral dorsalis pedis artery blood flow,bilateral dorsalis pedis artery inner diameter,bilateral popliteal artery blood flow,bilateral popliteal artery inner diameter,bilateral femoral artery blood flow,bilateral femoral artery inner diameter,and vascular stenosis.logistic stepwise regression analysis was used to analyze the related factors of different prognosis.ROC curve was used to analyze the predictive value of the influencing factors.There was no significant difference in gender,age,body mass index,duration of diabetes,hypertension,hyperlipidemia,and Wagner grade between the ineffective group and the effective group(P>0.05).The levels of C-reactive protein and erythrocyte sedimentation rate in the ineffective group were higher than those in the effective group,and the differences were statistically significant(P<0.05).The albumin level of the ineffective group was lower than that of the effective group,and the difference was statistically significant(P<0.05).There were no significant differences in hemoglobin,glycosylated hemoglobin,fasting blood glucose,urea nitrogen,creatinine,total cholesterol,triglyceride,alanine aminotransferase,and aspartate aminotransferase between the ineffective group and the effective group(P>0.05).In the ineffective group,the blood flow of the affected dorsal foot artery,the inner diameter of the affected dorsal foot artery,the blood flow of the affected popliteal artery,the inner diameter of the affected popliteal artery,the blood flow of the affected femoral artery,and the inner diameter of the affected femoral artery were lower than those of the effective group,and the difference was statistically significant(P<0.05).The degree of lower extremity arterial stenosis was also statistically significant between the ineffective group and the effective group(P<0.05).In multivariate logistic stepwise regression analysis,the results showed that C-reactive protein and the degree of lower extremity artery stenosis were independent risk factors for the prognosis of elderly patients with diabetic foot(P<0.05).The area under the ROC curve is shown,the area under the curve of lower extremity arterial stenosis combined with C-reactive protein was 0.768,the area under the curve of the degree of lower extremity arterial stenosis was 0.652,the area under the curve of C-reactive protein was 0.739,the area under the combined ROC curve was larger,which was better than the area under the single curve(P<0.05).In diabetic foot patients,only popliteal artery blood flow(P<0.05).There were no significant differences in dorsalis pedis artery blood flow,dorsalis pedis artery diameter,popliteal artery diameter,femoral artery blood flow,femoral artery diameter,and lower extremity artery stenosis(P>0.05).C-reactive protein and the degree of lower extremity artery stenosis are independent risk factors for the prognosis of elderly diabetic foot.The degree of lower extremity arterial stenosis detected by ultrasound and Creactive protein have certain value in predicting the prognosis of elderly patients with diabetic foot,However,the combined prediction of the two methods is more effective and valuable in evaluating the prognosis of patients. |
