The diabetic person beyond a foot ulcer - Healing, recurrence, and depressive symptoms
The diabetic person beyond a foot ulcer - Healing, recurrence, and depressive symptoms
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DOI：
10.7547/0980130
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发表时间：
2008-03-01
影响因子：
0.7
通讯作者：
Mannucci, Edoardo
中科院分区：
文献类型：
--
作者：
Monami, Matteo;Longo, Rosella;Mannucci, Edoardo
背景资料：一些研究表明抑郁症状与伤口愈合之间存在显著关系，但这些研究尚未评估抑郁症状对糖尿病足预后的影响。我们专门设计了我们的研究，以评估抑郁症状的愈合和复发的糖尿病足ulcers.Methods的作用：一个连续的系列80例2型糖尿病患者年龄60岁及以上的足部溃疡，参加了一项队列观察性研究，6个月的随访。入选后6个月内愈合的患者纳入12个月随访研究，以评估溃疡复发。抑郁症状进行了评估与老年抑郁scale.Results：愈合与一个较小的溃疡面积，溃疡发作和治疗之间的较短的延迟，较低的糖化血红蛋白，较高的踝臂指数。吸烟状况和德克萨斯和瓦格纳评分对愈合也有显著影响。愈合的患者在老年抑郁量表上的评分显著较低，而评分>= 10的患者在6个月时未愈合的风险显著较高（相对风险为3.57; 95%置信区间为1.05-12.2）。复发性溃疡患者（59.3%）的总胆固醇水平显著升高，疾病严重程度的格林菲尔德指数和老年抑郁量表得分较高，以及。脑血管疾病的患病率更高。抑郁症状与溃疡的持续性和复发保持显著相关性，即使在调整混杂因素后。结论：抑郁症状与老年2型糖尿病患者溃疡愈合不良和复发相关。
Background: Several studies have shown a significant relationship between depressive symptoms and wound healing, but these studies have not assessed the effects of depressive symptoms on diabetic foot prognosis. We specifically designed our study to assess the role of depressive symptoms in healing and recurrence of diabetic foot ulcers.Methods: A consecutive series of 80 type 2 diabetic patients aged 60 years and older with foot ulcers was enrolled in a cohort observational study with a 6-month follow-up. Patients who healed within 6 months of enrollment were included in a 12-month follow-up study for assessment of ulcer recurrence. Depressive symptoms were assessed with the geriatric depression scale.Results: Healing was associated with a smaller ulcer area, shorter delay between ulcer onset and treatment, lower glycosylated hemoglobin, and higher ankle-brachial index. Both smoking status and Texas and Wagner scores also had a significant impact on healing. Patients who healed had significantly lower scores on the geriatric depression scale, and those with scores >= 10 had a significantly higher risk of not healing at 6 months (relative risk, 3.57; 95% confidence interval, 1.05-12.2). Patients with a recurrent ulcer (59.3%) showed significantly higher total cholesterol levels, higher scores on the Greenfield index of disease severity and geriatric depression scale, and. a higher prevalence of cerebrovascular disease. Depressive symptoms maintained a significant association with persistence and recurrence of ulcer even after adjustment for confounders.Conclusions: Depressive symptoms are associated with impaired healing and recurrence of ulcers in elderly type 2 diabetic patients.