目的 分析糖尿病足溃疡（diabetic foot ulcer，DFU）患者愈合后复发的影响因素并构建风险预测模型。 方法 选取2017年1月至2019年12月我院收治的DFU患者263例作为研究对象，并根据随访2年内DFU复发情况将患者分为复发组（n=69）和未复发组（n=178）。 结果 两组患者年龄、糖尿病病程、糖化血红蛋白、C反应蛋白、白细胞计数、心脑血管病史、糖尿病周围神经病变、糖尿病视网膜病变、 Wagner分级、踝肱指数比较，差异均有统计学意义（均P＜0.05）；年龄（＞63岁）、糖尿病病程（＞10年）、糖化血红蛋白（＞9.07%）、白蛋白（≤39.57 g/L）、C反应蛋白（＞4.14 mg/L）、白细胞计数（＞7.09×109/L）是DFU患者愈合后复发的独立危险因素（均P＜0.05）。决策曲线结果显示，风险阈值＞0.22时，此预测模型可以提供显著额外的临床净收益。 结论 基于DFU愈合后复发的独立影响因素构建的风险预测模型，可为DFU患者的防治提供重要指导策略。

Objective To analyze the influencing factors of diabetic foot ulcer (DFU) recurrence among those patients with healing DFU,and construct a risk prediction model. Methods A total of 263 DFU patients admitted to a hospital from January,2017 to December,2019 were selected for the study.The participants were divided into the recurrence group(n=69) and the non-recurrence group(n=178) according to the recurrence of DFU within 2 years of follow-up. Results There were statistically significant differences in the age,course of diabetes,glycosylated hemoglobin,C-reactive protein (CRP),white blood cell (WBC) count,history of cardiocerebrovascular diseases,diabetic peripheral neuropathy,diabetic retinopathy,Wagner Classification and ankle-brachial index between the two groups (all P＜0.05).Age (＞63 years),course of diabetes (＞10 years),glycosylated hemoglobin (＞9.07%),albumin (≤39.57 g/L), CRP (＞4.14 mg/L) and WBC count (＞7.09×109/L) were independent risk factors of recurrence among DFU patients with healing DFU(all P＜0.05).The results of decision curve showed that the prediction model provided significantly additional clinical net benefits when the risk threshold was above 0.22. Conclusions The risk prediction model established on those independent influencing factors of recurrence after the healing of DFU can provide important guidance for DFU prevention and treatment among those patients.

R473.58