Correlation between the Controlling Nutritional Status score and wound repair of diabetic foot ulcer
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摘要:目的
探讨控制营养状况(COUNT)评分与糖尿病足溃疡(DFU)创面修复的相关性。
方法随机选取2019年11月20日—2022年11月20日在本院接受治疗的80例DFU患者为研究对象，根据创面修复情况的不同分为非创面修复组(n=47)和创面修复组(n=33)。记录创面修复与住院时间，比较创面修复组与非创面修复组的临床特征及CONUT评分，采用多因素Logistic回归模型分析DFU创面修复的影响因素。
结果非创面修复组患者的住院时间是16.00(10.50, 24.00) d, 短于创面修复组患者的44.00(31.00, 61.80) d, 差异有统计学意义(P < 0.05)。非创面修复组患者的总胆固醇(TC)、踝肱指数(ABI)、CONUT评分以及营养不良比率均高于创面修复组，差异有统计学意义(P < 0.05)。多因素Logistic回归分析结果显示, CONUT评分、营养不良、TC、ABI是DFU创面修复的独立危险因素(P < 0.05)。
结论DFU患者的营养不良、ABI、TC和CONUT评分均会对其创面修复造成不利影响，而CONUT评分可以准确预测患者的创面修复风险，可以作为临床医生早期评估DFU的可靠参考依据。
Abstract:ObjectiveTo investigate the correlation between the Controlling Nutritional Status (CONUT) score and wound repair of diabetic foot ulcer (DFU).
MethodsA total of 80 DFU patients treated in the Hospital from November 20, 2019 to November 20, 2022 were randomly selected as the study objects and divided into non-wound repair group (n=47) and wound repair group (n=33) based on wound repair status. Wound repair and hospital stay were recorded; clinical characteristics and the CONUT score were compared between the wound repair group and the non-wound repair group; the influencing factors of DFU wound repair were analyzed by the multivariate Logistic regression model.
ResultsThe hospital stay of patients in the non-wound repair group was 16.00 (10.50 to 24.00) days, which was significantly shorter than 44.00 (31.00 to 61.80) days of patients in the wound repair group (P < 0.05). The total cholesterol (TC), ankle-brachial index (ABI), the CONUT score, and malnutrition rate of patients in the non-wound repair group were significantly higher than those in the wound repair group (P < 0.05). The results of multivariate Logistic regression analysis showed that the CONUT score, malnutrition, TC and ABI were the independent risk factors for wound repair of DFU (P < 0.05).
ConclusionMalnutrition, ABI, TC and CONUT score in DFU patients can adversely affect wound repair, and the CONUT score can accurately predict the risk of wound repair in patients, serving as a reliable reference for clinicians in early assessment of DFU.
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表 1 创面修复组与非创面修复组的一般资料及临床特征比较(x±s)[n(%)][M(P25, P75)]
临床特征 非创面修复组(n=47) 创面修复组(n=33) 统计值 P 年龄/岁 59.16±10.86 57.11±11.71 0.805 0.423 男性 25(53.19) 20(60.61) 0.433 0.510 体质量指数/(kg/m2) 25.32±2.30 24.72±2.78 1.053 0.295 病程/年 13.59±8.42 10.14±6.73 1.955 0.054 收缩压/mmHg 136.03±16.70 132.11±15.92 1.053 0.295 舒张压/mmHg 75.10±8.80 75.02±8.74 0.040 0.968 服用阿司匹林 25(53.19) 11(33.33) 3.089 0.079 服用降脂药 18(38.30) 14(42.42) 0.138 0.711 吸烟史 33(70.21) 23(69.70) 0.002 0.960 营养不良 36(76.60) 15(45.45) 8.136 0.004 糖化血红蛋白/% 9.32±1.95 9.53±2.20 -0.450 0.654 餐后2 h血糖/(mmol/L) 16.55±4.73 17.07±4.86 -0.479 0.634 空腹血糖/(mmol/L) 9.03±3.81 9.21±3.10 -0.224 0.823 血清白蛋白/(g/L) 40.77±3.82 41.24±2.61 -0.613 0.542 淋巴细胞计数/(×109/L) 1.95±0.68 2.23±0.71 -1.780 0.079 总胆固醇/(mmol/L) 4.68±1.33 4.10±0.89 2.183 0.032 甘油三酯/(mmol/L) 1.67±0.77 1.36±0.58 1.955 0.054 低密度脂蛋白胆固醇/(mmol/L) 2.71±0.91 2.59±0.66 0.647 0.520 高密度脂蛋白胆固醇/(mmol/L) 1.23±0.24 1.29±0.20 -1.177 0.243 空腹胰岛素/(pmol/L) 52.31±20.66 51.19±20.68 0.239 0.812 踝肱指数 0.82±0.16 0.68±0.09 4.542 < 0.001 控制营养状况评分/分 2.75(0, 4.00) 1.00(0, 2.00) -3.317 0.001 1 mmHg=0.133 kPa。 
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表 2 DFU创面修复的多因素Logistic回归分析
变量 β SE Wald P OR(95%CI) 控制营养状况评分 0.988 0.436 5.121 0.024 2.685(1.141~6.314) 总胆固醇 0.087 0.044 3.895 0.048 1.091(1.001~1.190) 踝肱指数 -1.725 0.473 13.325 < 0.001 0.178(0.071~0.450) 营养不良 0.627 0.224 7.820 0.005 1.872(1.206~2.905)
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