自体全血外敷治疗糖尿病足慢性创面的临床研究  

Clinical study on external application of autologous whole blood in the treatment of chronic wound of diabetic foot

作　　者：胡凤丹 江丛元 黄靓[3] 廖若夷[4] 蔡华安[3] 段文欣 Hu Fengdan;Jiang Congyuan;Huang Liang;Liao Ruoyi;Cai Huaan;Duan Wenxin(The Third Department of Rehabilitation,the First Affiliated Hospital of Hunan Normal University,Hunan Provincial People′s Hospital,Changsha 410000,China;Anson Biological Technology Co.,Ltd,Changsha 410000,China;Hunan Provincial People′s Hospital,Laboratory of Sports Medicine,Institute of Translational Medicine,the First Affiliated Hospital of Hunan Normal University,Changsha 410000,China;The First Affiliated Hospital of Hunan University of Traditional Chinese Medicine,Changsha 410000,China)

机构地区：[1]湖南师范大学附属第一医院康复三科湖南省人民医院,长沙410000 [2]湖南安信生物科技有限公司,长沙410000 [3]湖南省人民医院湖南师范大学附属第一医院转化医学研究所运动医学研究室,长沙410000 [4]湖南中医药大学第一附属医院,长沙410000

出　　处：《中华糖尿病杂志》2022年第7期669-674,共6页CHINESE JOURNAL OF DIABETES MELLITUS

基　　金：湖南省人民医院与安可信创口连锁公司合作项目(H2020-16)。

摘　　要：目的:评价自体全血外敷在糖尿病足慢性创面治疗中的安全性和有效性,同时对该方法治疗的机制进行初步探讨。方法:选取湖南省人民医院康复三科2020年1至12月住院的糖尿病足慢性创面患者。按照随机数字表法,将患者分为对照组及试验组(自体全血组)。在积极控制基础疾病的情况下,两组患者均先进行蚕食清创,而后对照组采用活性氧和次氯酸成分消毒液(德维可)联合泡沫敷料治疗;试验组采用德维可、自体全血外敷联合泡沫敷料治疗。治疗当日及治疗第3、6、9、15天,观察局部创面情况,记录不良反应、创面愈合率、毛细血管计数和生长因子表达水平,其中生长因子包括血小板衍生长因子(PDGF)、血管内皮细胞生长因子(VEGF)、表皮生长因子(EGF)、转化生长因子-β1(TGF-β1)和胰岛素样生长因子-1(IGF-1)。两组患者的一般情况、毛细血管计数、生长因子表达、创面愈合率等采用独立样本t检验、χ^(2)检验比较。结果:40例糖尿病足慢性创面患者纳入研究,试验组和对照组各20例。两组患者的性别分布、年龄、创面面积、Wagner分级、糖化血红蛋白、白细胞数、合并高血压和高血脂、踝肱指数的差异均无统计学意义(P>0.05)。两组患者治疗后均无不良反应发生。治疗当日及第3天,两组创面愈合率和毛细血管计数的差异无统计学意义;第6、9、15天,两组差异有统计学意义(P<0.05),试验组均高于对照组。试验组和对照组创面肉芽组织中各生长因子(PDGF、VEGF、EGF、TGF-β1、IGF-1)均在第3天少量表达,第9、15天的表达量逐渐增强。两组间在治疗第3天的表达差异均无统计学意义,第9、15天的差异均有统计学意义(P<0.05),试验组均高于对照组。结论:自体全血能增加糖尿病足慢性创面的愈合率。自体全血可能通过增加糖尿病足慢性创面组织中毛细血管数和生长因子含量从而促进创面愈�Objective To evaluate the safety and efficacy of autologous whole blood external application in treating diabetes foot chronic wounds,and to explore the mechanism of the therapy.Methods The patients with chronic wounds of diabetes foot admitted to Hunan People′s Hospital from January to December in 2020 were enrolled.According to the random number table method,the patients were divided into control group and experimental group(autologous whole blood group).In the case of active control of underlying diseases,two groups of patients were advanced to nibble debridement,and the control group was treated with active oxygen and hypochlorite disinfectant(DAVIC)combined with foam dressing.The experimental group was treated with DAVIC,autologous whole blood external application combined with foam dressing.On the day of treatment and the 3rd,6th,9th and 15th days of treatment,the local wound conditions were observed,adverse reactions,wound healing rate,capillary count and growth factor expression were recorded.The growth factors included platelet derived growth factor(PDGF),vascular endothelial growth factor(VEGF),epidermal growth factor(EGF)and transforming growth factor-β1(TGF-β1)and insulin-like growth factor-1(IGF-1).The general condition,capillary count,growth factor expression and wound healing rate of the two groups were compared by independent sample t-test andχ^(2) test.Results Forty patients with chronic wounds of diabetes foot were included in the study.There were 20 cases in the experimental group and 20 cases in the control group.There was no significant difference in gender distribution,age,wound area,Wagner grade,glycosylated hemoglobin,leukocyte count,hypertension and hyperlipidemia,ankle brachial index between the two groups(P>0.05).There were no adverse reactions in both groups after treatment.There was no significant difference in wound healing rate and capillary count between the two groups on the day and the third day of treatment;on the 6th,9th and 15th day,there was significant difference betwee

关 键 词：糖尿病足 自体全血 慢性创面 生长因子 

分 类 号：R587.2[医药卫生—内分泌]