2型糖尿病足初期周围血管病变介入治疗及对VEGF、TGF-β的影响  

Influence of interventional treatment of early peripheral vascular disease on the VEGF,TGF-βin diabetic foot patients

作　　者：金一琦[1] 徐国雄[1] 张志轩[1] 沈利明[1] 

机构地区：[1]苏州市立医院本部血管外科,江苏苏州215002

出　　处：《中国血管外科杂志（电子版）》2015年第3期191-194,共4页Chinese Journal of Vascular Surgery(Electronic Version)

摘　　要：目的探讨介入治疗对2型糖尿病足(DF)初期周围血管病变的临床疗效及对血管内皮生长因子(VEGF)、转化生长因子(TGF-β)的影响。方法将38例DF患者随机数字表法随机分为介入组(19例)和对照组(19例)。对照组采用营养神经药物及局部换药等保守治疗,介入组同时给予经皮腔内血管成形术(PTA)和(或)血管内支架植入术。比较两组治疗前、后的临床疗效、临床症状评分、ABI及VEGF、TGF-β水平的变化。结果介入组总有效率为89.5%,显著高于对照组52.6%(χ2=4.38,P<0.05);治疗后,两组疼痛、冷感、麻木感评分均较治疗前显著降低,但对照组间歇性跛行评分与治疗前比较,差异无统计学意义(P>0.05);介入组治疗后各临床症状评分均显著低于对照组(P<0.05)。治疗后,介入组ABI及VEGF、TGF-β水平显著升高,且明显高于对照组(P<0.05)。结论 DF患者初期周围血管病变及时行介入治疗可缓解临床症状,同时提高VEGF、TGF-β水平,改善预后。Objective To explore the influence of interventional treatment of early peripheral vascular disease on the VEGF, TGF-β in diabetic foot（DF） patients. Methods Thirty-eight DF patients were randomly divided into control group（n =19） and intervene group（n =19） by random number table. Control group was treated with conservative treatment such as nerve nutrition drugs and local dressing changes and so on, and intervene group was treated percutaneous transluminal angioplasty（PTA） and（or） stenting implantation. The clinical effect, clinical symptom score and the level of VEGF and TGF-β in two groups before and after treatment were observed and compared. Results The total effective rate in intervene group was significantly higher than that of control group（89.5% vs 52.6%）（χ2=4.38, P〈0.05）. The scores of pain,cold feeling, numbness after treatment were significantly lower than those before treatment in both groups（P〈0.05）, but scores of intermittent claudication was not improved in control group（P〉0.05）. All scores of subjective symptom in intervene group was lower than those in control group after treatment（P〈0.05）. ABI and the level of VEGF and TGF-β in intervene group increased significantly after treatment, and were higher than those in control group（P〈0.05）. A. Conclusions Timely intervention for the peripheral vascular disease in DF patients can alleviate subjective symptoms, raise the level of VEGF and TGF-β, and improve the prognosis.

关 键 词：糖尿病足 周围血管病变 血管内皮生长因子 转化生长因子 

分 类 号：R587.2[医药卫生—内分泌]