贵州医科大学学报

2020, v.45;No.243(12) 1464-1468

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自体富血小板凝胶治疗难治性糖尿病足溃疡的疗效和机制
Efficacy of Autologous Platelet Rich Gel in Treatment of Refractory Diabetic Foot Ulcers and its Mechanism

胡丽;皮银珍;胡韵婷;王环君;赵晋晋;
HU Li;PI Yinzhen;HU Yunting;WANG Huanjun;ZHAO Jinjin;Department of Endocrinology and Metabolism,the First Hospital of Changsha;

摘要(Abstract):

目的:探讨自体富血小板凝胶(APRG)治疗难治性糖尿病足溃疡的疗效及其作用机制。方法:90例难治性糖尿病足溃疡患者随机均分为对照组(常规创面治疗,n=45)和观察组(常规创面联合APRG治疗,n=45),均治疗28 d;收集2组患者入院时基础资料和血液常规生化指标;于治疗前和治疗28 d后分别抽取2组患者空腹静脉血5 m L,采用酶联免疫吸附测定(ELISA)法测定血清肿瘤坏死因子-α(TNF-α)、白细胞介素-1(IL-1)、血管内皮生长因子(VEGF)、表皮生长因子(EGF)水平;采用中国糖尿病足防治指南(2019版)标准评价2组患者治疗结束时的治疗效果。结果:2组患者治疗后血清TNF-α和IL-1水平均分别低于治疗前,且观察组低于对照组(P <0. 05); 2组患者治疗后血清VEGF和EGF水平均分别高于治疗前,且观察组高于对照组(P <0. 05);观察组患者治疗后总有效率(88. 89%)高于对照组(71. 11%),差异有统计学意义(χ~2=4. 444,P=0. 035)。结论:APRG可有效治疗难治性糖尿病足溃疡,其治疗机制可能与降低炎症因子水平、促进表皮生长有关。
Objective: To investigate the efficacy and mechanism of autologous platelet rich gel( APRG) in the treatment of refractory diabetic foot ulcers. Methods: Ninety patients with refractory diabetic foot ulcers were randomly divided into the control group( conventional wound therapy,n =45) and the observation group( conventional wound treatment combined with APRG,n = 45). Both groups were treated for 28 d. The basic data and clinical routine biochemical indexes were collected.Before and 28 d after treatment,5 m L of fasting venous blood was collected from the two groups,and the levels of TNF-α,IL-1,VEGF,and EGF were measured by enzyme-linked immunosorbent assay( ELISA). The curative effect of the two therapies in the end of treatment was evaluated by the Chinese Diabetes Foot Prevention and Treatment Guidelines( 2019). Results: After treatment,the serum TNF-α and IL-1 levels in the two groups were lower than those before treatment,and those in the observation group were lower than those in the control group( P < 0. 05); And the serum VEGF and EGF levels in the two groups were higher than those before treatment,and those in the observation group were higher than those in the control group( P < 0. 05); The total effective rate of the observation group after treatment( 88. 89%) was higher than that in the control group( 71. 11%),and the difference was statistically significant( χ~2= 4. 444,P = 0. 035). Conclusion: APRG can effectively treat refractory diabetic foot ulcers,and its mechanism is related to reducing inflammatory factors and promoting epidermal growth.

关键词(KeyWords): 糖尿病;足溃疡;表皮生长因子;难治性;自体富血小板凝胶;炎症因子;作用机制
diabetes mellitus;foot ulcer;epidermal growth factor(EGF);refractory;autologous platelet rich gel(APRG);inflammatory factors;mechanism of action

Abstract:

Keywords:

基金项目(Foundation): 湖南省卫生计生委科研计划课题项目(B2016158);; 长沙市科技计划项目(kq1907017)

作者(Author): 胡丽;皮银珍;胡韵婷;王环君;赵晋晋;
HU Li;PI Yinzhen;HU Yunting;WANG Huanjun;ZHAO Jinjin;Department of Endocrinology and Metabolism,the First Hospital of Changsha;

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DOI: 10.19367/j.cnki.2096-8388.2020.12.019

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