腔内手术治疗糖尿病足的临床疗效观察及白介素-35、核因子Kappa B水平变化分析  

To observe the clinical effect of percutaneous transluminal angioplasty treat diabetic foot and interleukin-35, nuclear factor Kappa B level change analysis

作　　者：王晋军[1] 王兆伟[1] 李林[1] 陈啸[1] 姜桂喜 WANG Jin-jun;WANG Zhao-wei;LI Lin;CHEN Xiao;JIANG Gui-xi(Vascular surgery, Haici Hospital Affi liated Qingdao University, Qingdao, Shandong, 266033)

机构地区：[1]青岛大学附属海慈医院血管外科,山东青岛266033

出　　处：《临床普外科电子杂志》2017年第2期75-80,共6页Journal of General Surgery for Clinicians(Electronic Version)

摘　　要：目的观察糖尿病足患者应用腔内手术治疗(percutaneous transluminal angioplasty,PTA)的临床疗效及对血清白介素-35(IL-35)和核因子-Kappa B(NF-κB)水平的影响。方法将120例患者分为常规组和腔内治疗组(PTA组)各60例。两组患者均实施控制血糖、改善循环、抗血小板及营养神经等治疗。PTA组:在常规组基础上应用腔内手术的方法,遵循足部血管区域Angiosome理念及足背-底弓(plantar-pedal loop,PPL)技术开通闭塞的膝下主干动脉。以上患者均持续用药4周。结果 PTA组临床疗效优于常规组,复发率低于常规组,差异有统计学意义(P<0.05);PTA组治疗后足背动脉内径、血流速度、ABPI及TBPI、TcPO_2明显提高(P<0.01)。PTA组相比于常规组新生侧支血管量明显增加(P<0.05);PTA组治疗后IL-35和NF-κB水平均有显著降低。结论腔内手术治疗糖尿病足疗效显著,其提高ABI及TcPO_2,改善局部血运、增加侧支循环的机制可能与调节IL-35和NF-κB水平相关。Objective To observe the the clinical effect of diabetic foot patients with PTA.Analysis the change of interleukin-35(IL-35)and nuclear factor Kappa B(NF-κB)levels.Methods One hundred and twenty patients were divided into two groups:normal group,the PTA group,60cases in each group.Two groups of patients be controled the blood sugar,improve circulation,antiplatelet,Improve nerve function,etc.PTA group:on the basis of normal group,PTA was given.Results Effi cient:Two groups of patients with clinical curative effect comparison,joint clinical curative effect is superior to normal group,the PTA recurrence rate is lower than the normal group,the difference was statistically significant(P<0.05);vessels and blood flow index of groups of dorsalis pedis artery diameter and blood flow velocity before and after the treatment,ABPI and TBPI,TcPO2were increased signifi cantly(P<0.01).PTA group curative effect is superior to the normal group;Imaging examination:PTA group compared with the normal collateral vessels volume increased signifi cantly(P<0.05).The new amount of collateral vessels were signifi cantly increased(P<0.05);related cytokines:IL-35after PTA group was signifi cantly reduced,(P<0.05).Conclusion PTA for diabetic foot of arteries,its increase ABI and TcPO2,improving local blood supply,increasing collateral circulation may be related to regulating IL-35and NF-κB level.

关 键 词：腔内手术 糖尿病足 临床疗效 白介素-35 核因子KAPPAB 

分 类 号：R696[医药卫生—泌尿科学]