负压封闭引流联合前列地尔促进糖尿病足溃疡创面愈合的疗效和机制研究  

Study on the effect and mechanism of alprostadil in promoting wound healing of diabetic foot ulcer

作　　者：李松泽[1] 荣新洲[1] 张涛[1] 樊桂成[1] 王震[1] 刘思容[1] 刘忠考 王学敏[1] 温学良 Li Songze;Rong Xinzhou;Zhang Tao;Fan Guicheng;Wang Zhen;Liu Sirong;Liu Zhongkao;Wang Xuemin;Wen Xueliang(Department of Burns, Guangzhou First People′s Hospital, Guangzhou 510180, China)

机构地区：[1]广州市第一人民医院烧伤科,510180

出　　处：《中华损伤与修复杂志（电子版）》2020年第2期133-138,共6页Chinese Journal of Injury Repair and Wound Healing(Electronic Edition)

基　　金：广州市卫生局医药卫生科技项目(20171A011240)。

摘　　要：目的探讨负压封闭引流联合前列地尔促进糖尿病足溃疡创面愈合的疗效及机制。方法将广州市第一人民医院烧伤科2017年1月至2018年12月收治的43例采用负压封闭引流进行治疗的糖尿病足溃疡患者按随机数字表法分为观察组(n=23)和对照组(n=20),2组患者均进行负压封闭引流治疗,在此基础上观察组联合静脉滴注前列地尔。治疗前及治疗第7、14天,分别采集2组患者晨空腹静脉血3 mL;治疗第7、14天,采集患者引流袋中引流液5 mL,离心取上清液,移入已消毒的Eppendorf管中,密封,冻存于-80℃低温冰箱,并于患者更换负压材料时取部分肉芽组织,10%甲醛固定,石蜡切片。分别检测观察组及对照组患者治疗前,治疗第7、14天血液中降钙素原和血清白蛋白含量及治疗第7、14天引流液中的一氧化氮、血管内皮生长因子(VEGF)、肉芽组织晚期糖基化终末产物受体(RAGE)及腐胺含量,数据比较采用t检验和χ2检验。结果治疗前2组患者降钙素原和血清白蛋白含量比较差异无统计学意义(P值均大于0.05);治疗第7、14天,观察组降钙素原分别为(0.61±0.46)、(0.30±0.28)ng/mL,低于对照组(0.93±0.47)、(0.49±0.29)ng/mL,差异均有统计学意义(t=-2.21、-2.15,P=0.03、0.04);观察组血清白蛋白[(27.13±2.13)、(28.78±1.90)g/L],高于对照组[(25.48±2.66)、(25.48±2.66)g/L],差异均有统计学意义(t=2.17、3.18,P=0.04、<0.01)。观察组治疗第7、14天引流液中一氧化氮含量分别为(86.30±5.82)、(106.97±6.44)μmol/L,浓度高于对照组[(65.64±5.76)、(84.80±9.19)μmol/L],差异均有统计学意义(t=11.67、9.25,P值均小于0.01);VEGF含量分别为(123.04±11.76)、(240.15±38.85)pg/mL,浓度高于对照组[(85.09±6.72)、(129.57±17.28)pg/mL],差异均有统计学意义(t=12.72、11.74,P值均小于0.01);观察组治疗第7、14天,引流液中腐胺浓度为(0.63±0.08)、(0.22±0.08)mg/L,低于对照组[(0.81±0.09)、(0.41±0.08)mg/L],差异均�Objective To investigate the effect and mechanism of vacuum sealing drainage combined with alprostadil in promoting wound healing of diabetic foot ulcer.Methods Fourty three patients with diabetic foot ulcer treated with vacuum sealing drainage from January 2017 to December 2018 in the Department of Burns,Guangzhou First People′s Hospital were divided into observation group(n=23)and control group(n=20)according to the random number table method.Both groups were treated with vacuum sealing drainage,and the observation group combined with intravenous infusion of alprostadil.Before and on the 7th and 14th day of treatment,3 mL of morning fasting venous blood was collected from the two groups of patients.On the 7th and 14th day of treatment,5 mL of drainage fluid from the patient′s drainage bag was collected,the supernatant was centrifuged,and transferred to the sterilized Eppendorf tube and sealed,frozen in-80℃low-temperature refrigerator.When the patients changed the negative pressure material,some granulation tissue was taken,fixed with 10%formaldehyde,and the paraffin sections was made.The levels of procalcitonin and serum albumin in the blood of the observation group and the control group were detected before,on the 7th and 14th day of treatment.The nitric oxide and vascular endothelial growth factor(VEGF)in the drainage fluid on the 7th and 14th day of treatment,and the granulation tissue receptor for advanced glycation end products(RAGE)and putrescine content were detected.Data were compared with t test andχ2 test.Results There was no significant difference in the content of procalcitonin and serum albumin between the two groups before treatment(with P values above 0.05).On the 7th and 14th day of treatment,the procalcitonin in the observation group was(0.61±0.46)and(0.30±0.28)ng/mL,lower than those in the control group[(0.93±0.47)and(0.49±0.29)ng/mL],the differences were statistically significant(t=-2.21,-2.15;P=0.03,0.04).The serum albumin was(27.13±2.13)and(28.78±1.90)g/L in the observation gro

关 键 词：糖尿病足 溃疡 前列地尔 创面 

分 类 号：R47[医药卫生—护理学]