胰岛素局部应用对糖尿病足患者血清炎性因子、VEGF、氧化应激和创面组织β-catenin表达的影响  

The Effect of Local Application of Insulin on the Expression of Serum Inflammatory Factors,VEGF,Oxidative Stress andβ-Catenin in Diabetic Foot

作　　者：郑海龙[1] 吴海丽 王海凤 陈小盼[1] 李晓燕 蔡舒婷 罗志飞[3] ZHENG Hai-long;WU Hai-li;WANG Hai-feng;CHEN Xiao-pan;LI Xiao-yan;CAI Shu-ting;LUO Zhi-fei(Department of Endocrinology,the First Affiliated Hospital of Hainan Medical College,Haikou,Hainan,570102,China;Department of Dermatology and Venereology the First Afiliated Hospital of Hainan Medical College,Haikou,Hainan,570102,China;Department of Pathology,the First Affiliated Hospital of Hainan Medical College,Haikou,Hainan,570102,China)

机构地区：[1]海南医学院第一附属医院内分泌科,海南海口570102 [2]海南医学院第一附属医院皮肤性病科,海南海口570102 [3]海南医学院第一附属医院病理科,海南海口570102

出　　处：《现代生物医学进展》2020年第18期3558-3562,共5页Progress in Modern Biomedicine

基　　金：海南省卫生计生行业科研项目(16A200055)。

摘　　要：目的:研究胰岛素局部应用对糖尿病足(DF)患者血清炎性因子、血管内皮生长因子(VEGF)、氧化应激和创面组织β-catenin表达的影响,旨在为临床DF患者的治疗提供理论依据。方法:将2017年4月至2019年12月于我院接受诊治的90例DF患者纳入研究,按照随机信封法将其分成观察组及对照组各45例。对照组实施负压吸引(NPWT)治疗,观察组则于NPWT治疗的基础上增用胰岛素治疗。比较两组治疗前后创面面积、炎性因子、血管内皮生长因子(VEGF)水平、氧化应激和创面组织β-catenin表达变化情况。结果:治疗后观察组及对照组创面面积均少于治疗前,且观察组少于对照组(均P<0.05)。治疗后观察组及对照组血清白细胞介素-1(IL-1)及肿瘤坏死因子-α(TNF-α)均低于治疗前,而VEGF水平高于治疗前(均P<0.05);治疗后观察组血清IL-1及TNF-α均低于对照组,而VEGF水平高于对照组(均P<0.05)。治疗后观察组及对照组丙二醛(MDA)水平低于治疗前,而超氧化物歧化酶(SOD)水平高于治疗前(均P<0.05);治疗后观察组MDA水平低于对照组,而SOD水平高于对照组(均P<0.05)。治疗后观察组及对照组创面组织β-catenin表达水平均高于治疗前,且观察组高于对照组(均P<0.05)。结论:胰岛素局部应用可促进DF患者的创面愈合,同时有利于下调血清炎性因子水平,减轻氧化应激反应,其主要作用机制可能与上调创面组织VEGF、β-catenin表达有关。Objective:To study the effect of local application of insulin on the expression of serum inflammatory factors,VEGF,oxidative stress andβ-catenin in diabetic foot(DF),so as to provide theoretical basis for the treatment of DF.Methods:90 patients with DF who were treated in our hospital from April 2017 to December 2019 were included in the study.According to the random envelope method,they were divided into observation group and control group with 45 cases each.The control group was treated with NPWT,while the observation group was treated with insulin on the basis of NPWT.The changes of wound area,inflammatory factor,vascular endothelial growth factor(VEGF),oxidative stress andβ-catenin expression in wound tissue before and after treatment were compared between the two groups.Results:After treatment,the wound area in the observation group and the control group was less than that before treatment,and that in the observation group was less than that in the control group(all P<0.05).After treatment,the levels of IL-1 and TNF-αin the observation group and the control group were lower than those before treatment,while the levels of VEGF were higher than those before treatment(all P<0.05);after treatment,the levels of IL-1 and TNF-αin the observation group were lower than those in the control group,while the levels of VEGF were higher than those in the control group(all P<0.05).After treatment,the MDA level in the observation group and the control group was lower than that before treatment,while the SOD level was higher than that before treatment(all P<0.05);after treatment,the MDA level in the observation group was lower than that in the control group,while the SOD level was higher than that in the control group(all P<0.05).After treatment,the expression level ofβ-catenin in the wound tissue of the observation group and the control group was higher than that before treatment,and the expression level ofβ-catenin in the observation group was higher than that of the control group(P<0.05).Conclusion:Local application

关 键 词：糖尿病足 胰岛素 负压吸引 炎性因子 血管内皮生长因子 

分 类 号：R587.2[医药卫生—内分泌]