中文摘要
　　本研究目的為探討糖尿病患者足部潰瘍之相關因素，針對人口學特性、疾病狀況、足部病變、足部自我照顧知識和行為等方面加以分析探討。採病例對照研究法（case-control study），自93年10月至94年3月中旬，於南部地區一所醫學中心進行收案，收集因足部潰瘍住院或門診之糖尿病患者為病例組61位，及內分泌新陳代謝科門診無足部潰瘍之糖尿病患者為對照組122位。資料收集經人體試驗委員會審查通過及患者之同意。研究者將透過病例記錄查閱、結構性問卷、及足部理學檢查方式收集相關資料。統計分析將採用SPSS For Windows 11.0版之統計軟體，以計數、百分比、最大/最小值、平均值及標準差、卡方檢定（Chi-square test）、t 檢定（t-test）及對數迴歸（logistic regression）進行統計與分析。

　　研究結果顯示，病例組病患的年齡高於對照組（p < .01），在疾病狀況方面，病例組病患的糖化血色素高於對照組（9.68 ± 2.70 %、7.80 ± 1.70 % , p = .000），同時，糖尿病罹病期與視網膜病變皆顯著高於對照組。在足部病變方面，病例組比對照組病患較多併發有周邊神經病變、周邊血管病變、足部變形及皮膚狀況異常（p < .01）。此外，病例組足部自我照顧知識及行為得分皆低於對照組（p < .01）。

　　進一步經 logistic regression中多變項分析，發現糖化血色素、周邊神經病變、周邊血管病變、皮膚狀況及足部自我照顧行為是發生足部潰瘍之獨立預測因素，並顯示當病患糖化血色素越高，其足部潰瘍的危險性增加1.47倍（95% CI, 1.05-2.06; p = .025），若糖尿病患者患有周邊神經病變、周邊血管病變及足部皮膚異常時，其發生足部潰瘍的危險性各為20.27倍（95% CI, 2.96-138.68; p = .002）、5.67倍（95% CI, 1.63-19.79; p = .007）、17.58倍（95% CI, 3.37-91.71; p = .001），且病患足部自我照顧行為得分越高，發生足部潰瘍的危險性較低（OR= .89, 95% CI = .84–.95; p = .000）。

　　本研究結果可提供醫護人員確認糖尿病患者足部潰瘍之主要相關因素，並可運用非侵入性足部檢測工具，用來檢測糖尿病足部問題，以協助護理人員早期確認糖尿病足部潰瘍之高危險患者，期能早期預防，以降低糖尿病足之罹患率。

Abstract
　The purpose of this study is to investigate the factors that associated with foot ulceration in patients with diabetes. A case control study was conducted in a medical center at southern Taiwan. The studied factors included demographic characteristics, disease conditions, foot deformities, and structured questionnaires for diabetic foot-care knowledge, and foot-care behaviors. Sixty-one diabetic patients with foot ulcers and 122 diabetic patients without foot ulcers were recruited. SPSS software for windows version 11.0 was applied to analyze the data through descriptive statistic, chi-square, t-test, and logistic regression analyses.

　The results indicated that the patients with foot ulcers were older, and had higher A1C level (9.68 ± 2.70 % vs. 7.80 ± 1.70 %, p = .000), longer diabetes history, and higher prevalence of retinopathy than those without foot ulcers. Patients with foot ulceration were also found to have higher prevalence of peripheral neuropathy, peripheral vascular disease, foot deformities, and abnormal dermatological conditions (p < .01), and lower diabetic foot-care knowledge and foot-care behavior scores ( p < .01) than those without.

　The findings of multivariate logistic regression analysis suggested that peripheral neuropathy (OR, 20.27; 95% CI, 2.96-138.68; p = .002), peripheral vascular disease (OR, 5.67; 95% CI, 1.63-19.79; p = .007), dermatological conditions (OR, 17.58; 95% CI, 3.37-91.71; p = .001), A1C (OR, 1.47; 95% CI, 1.05-2.06; p = .025), and foot-care behavior (OR= .89, 95% CI = .84-.95; p = .000) are the independent prediction factors associated with development of diabetic foot ulcer.

　The findings of this study clearly disclosed factors that related to diabetic foot ulceration that can be detected by simple non-intrusive instruments and structured questionnaires. Therefore, the patients with high risk of diabetic foot ulcers could be early recognized and treated to reduce the incidence of diabetic foot ulcer among the diabetes patients.

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