局部注射脐带间充质干细胞治疗糖尿病足的效果及潜在机制  

Effect and potential mechanism of local injection of umbilical cord mesenchymal stem cells in treatment of diabetic foot

作　　者：随萍[1] 宋丽娟[2] 卢颖[2] 王海滨[3] SUI Ping;SONG Lijuan;LU Ying;WANG Haibing(Department of Diagnostics, Jining Medical College, Jining 272067, Shandong, China;Department of Endocrinology, East Hospital District, Jining First People's Hospital, Jining 272104, Shandong, China;Department of Traumatology and Orthopaedics, The Affiliated Hospital of Jining Medical College, Jining 272006, Shandong, China)

机构地区：[1]济宁医学院诊断学教研室,山东济宁272067 [2]济宁市第一人民医院东院区内分泌科,山东济宁272104 [3]济宁医学院附属医院创伤骨科,山东济宁272006

出　　处：《西部医学》2020年第11期1664-1668,共5页Medical Journal of West China

基　　金：济宁市医药卫生科技发展计划项目(JNSKJJ201101)。

摘　　要：目的研究脐带间充质干细胞(UCMSC)治疗糖尿病足的效果及潜在机制。方法选取2017年2月~2019年6月济宁市第一人民医院东院区接受诊治的86例糖尿病足患者作为观察对象,按照随机数字表法分为对照组和观察组,每组各43例。对照组患者采用常规疗法治疗,观察组患者接受静脉联合局部注射UCMSC治疗。对比两组治疗前后的足部体征评分、Wagner分级、血清炎症指标、血管内皮生长因子(VEGF)、碱性成纤维细胞生长因子(bFGF)和基质细胞衍生因子-1α(SDF-1α)水平及总有效率。结果观察组患者治疗后的足部皮肤温度、疼痛程度、皮肤色泽、踝肱指数和间歇性跛行评分较对照组明显增加(P<0.05),Wagner分级和血清肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)、超敏C反应蛋白(hs-CRP)水平较对照组明显降低(P<0.05),VEGF、bFGF和SDF-1α水平较对照组明显升高(P<0.05)。观察组治疗总有效率明显高于对照组(P<0.05)。结论静脉联合局部注射脐带间充质干细胞治疗糖尿病足能明显减轻患者足部症状,降低患者Wagner分级,提高疗效,其机制可能与抗炎和促进血管新生作用相关。Objective To investigate the effect and potential mechanism of umbilical cord mesenchymal stem cells(UCMSC)in the treatment of diabetic foot.Methods 86 patients with diabetic foot diagnosed and treated from February 2017 to June 2019 were selected as the study objects.According to the random number table method,they were divided into control group and observation group,43 cases in each group.Patients in the control group were treated with conventional therapy,while patients in the observation group were treated with intravenous injection and local injection of UCMSC.The foot sign score,Wagner grade,serum inflammation index,vascular endothelial growth factor(VEGF),basic fibroblast growth factor(bFGF),and stromal cell derived factor-1α(SDF-1α)levels and total effective rate of the two groups were compared before and after treatment.Results The skin temperature,pain degree,skin color,ankle brachial index and intermittent lameness score of the foot in the observation group were significantly higher than those in the control group(P<0.05).Wagner grade and serum levels of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),high sensitivity-C reactive protein(hs-CRP)in the observation group were significantly lower than those in the control group(P<0.05).The serum levels of VEGF,bFGF and SDF-1αin the observation group were significantly higher than those in the control group(P<0.05).The total effective rate in the observation group was significantly higher than that in the control group.Conclusion Intravenous injection combined with local injection of umbilical cord mesenchymal stem cells has a significant effect on diabetic foot,and the mechanism of action is related to anti-inflammatory and promoting angiogenesis.

关 键 词：糖尿病 糖尿病足 脐带间充质干细胞 机制 

分 类 号：R587.2[医药卫生—内分泌]