前列地尔联合封闭负压引流术对2型糖尿病足的临床疗效及对溃疡愈合、溃疡区微炎症状态、足背动脉血流动力学和血管新生指标的影响  

Clinical efficacy of alprostadil combined with vacuum sealing drainage on type 2 diabetic foot and its influence on ulcer healing,micro-inflammation status in ulcer area,hemodynamics of dorsal foot artery and angiogenesis indexes

作　　者：董俊 DONG Jun(Department of Endocrinology,Affiliated Hospital of Jiujiang University,Jiujiang 332000,China)

机构地区：[1]九江学院附属医院内分泌科,332000

出　　处：《中国实用医药》2022年第26期11-15,共5页China Practical Medicine

摘　　要：目的探讨前列地尔联合封闭负压引流术(VSD)对2型糖尿病足的临床疗效及对溃疡愈合、溃疡区微炎症状态、足背动脉血流动力学和血管新生指标的影响。方法86例2型糖尿病足患者,采用随机数字表法分为对照组和病例组,各43例。对照组在对症综合治疗基础上予以VSD,病例组在对照组基础上予以注射用前列地尔。比较两组患者临床疗效、溃疡相关指标、溃疡愈合情况、溃疡区微炎症状态、足背动脉血流动力学、血管新生指标及不良反应发生情况。结果病例组总有效率95.35%高于对照组的81.40%,差异具有统计学意义(P<0.05)。治疗后,两组患者溃疡面积、创面pH值小于治疗前,创面氧分压高于治疗前,且病例组患者溃疡面积、创面p H值小于对照组,创面氧分压高于对照组,差异有统计学意义(P<0.05)。治疗后,病例组溃疡愈合时间(19.56±4.25)d和溃疡面肉芽组织出现时间(6.85±1.83)d短于对照组的(23.46±5.47)、(9.52±2.64)d,差异有统计学意义(P<0.05)。治疗后,两组患者白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)低于治疗前,且病例组患者IL-6、IL-8、TNF-α、CRP低于对照组,差异有统计学意义(P<0.05)。治疗后,两组患者血管内径、血流流速、搏动指数(PI)和阻力指数(RI)大于治疗前,且病例组患者血管内径、血流流速、PI、RI大于对照组,差异有统计学意义(P<0.05)。治疗后,两组患者碱性成纤维细胞生长因子(bFGF)、血管内皮生长因子(VEGF)、胰岛素样生长因子-1(IGF-1)高于治疗前,基质金属蛋白酶-2(MMP-2)低于治疗前,且病例组患者bFGF、VEGF、IGF-1高于对照组,MMP-2低于对照组,差异有统计学意义(P<0.05)。对照组不良反应发生率为11.63%,病例组不良反应发生率为4.65%。两组不良反应发生率比较差异无统计学意义(P>0.05)。结论前列地尔联合VSD有利于改善2型糖尿病足溃疡区�Objective To discuss the clinical efficacy of alprostadil combined with vacuum sealing drainage(VSD)on type 2 diabetic foot and its influence on ulcer healing,micro-inflammation status in ulcer area,hemodynamics of dorsal foot artery and angiogenesis indexes.Methods A total of 82 patients with type 2 diabetic foot were divided into a control group and a case group,with 43 cases in each group according to random numerical table.The control group was treated with VSD on the basis of symptomatic comprehensive treatment,and the case group was treated with injectable prostaglandin on the basis of the control group.Both groups were compared in terms of clinical efficacy,ulcer-related indexes,ulcer healing,micro-inflammation status in ulcer area,hemodynamics of dorsal foot artery,angiogenesis indexes and the occurrence of adverse reactions.Results The total effective rate of 95.35%in the case group was higher than 81.40%in the control group,and the difference was statistically significant(P<0.05).After treatment,the ulcer area and wound pH value in both groups were smaller than those before treatment in this group,and the partial pressure of oxygen in the wound was higher than that before treatment in this group;the ulcer area and wound pH value in the case group were smaller than those in the control group;the partial pressure of oxygen in the wound in the case group was higher than that in the control group;the differences were all statistically significant(P<0.05).After treatment,the ulcer healing time(19.56±4.25)d and appearance of granulation tissue at the base of ulcers(6.85±1.83)d in the case group were shorter than(23.46±5.47)and(9.52±2.64)d in the control group,and the differences were all statistically significant(P<0.05).After treatment,the interleukin-6(IL-6),interleukin-8(IL-8),tumor necrosis factor-α(TNF-α),and C-reactive protein(CRP)in both groups were lower than those before treatment in this group;patients in the case group had lower IL-6,IL-8,TNF-α,and CRP than the control group;the differences

关 键 词：前列地尔 封闭负压引流术 糖尿病足 微炎症状态 新生血管 

分 类 号：R587.2[医药卫生—内分泌]