硫辛酸联合自体富血小板凝胶治疗糖尿病足创面修复及抗凝血酶的影响  

Effect of lipoic acid combined with autologous platelet-rich gel on diabetic foot wound repair and antithrombin

作　　者：潘晓霞[1] 王建福[2] 王卿一 杨波[3] PAN Xiao-xia;WANG Jian-fu;WANG Qing-yi;YANG Bo(Department of Endocrinology,Jinan Fourth People's Hospital,Jinan 250031,Shandong Province,China;Department of Radiology,Jinan Fourth People's Hospital,Jinan 250031,Shandong Province,China;Department of Burn and Plastic Surgery,Jinan Fourth People's Hospital,Jinan 250031,Shandong Province,China)

机构地区：[1]济南市第四人民医院内分泌科,山东济南250031 [2]济南市第四人民医院放射科,山东济南250031 [3]济南市第四人民医院烧伤整形科,山东济南250031

出　　处：《中国临床药理学杂志》2023年第24期3603-3607,共5页The Chinese Journal of Clinical Pharmacology

摘　　要：目的 观察硫辛酸联合自体富血小板凝胶(PRG)治疗糖尿病足患者创面修复及抗凝血酶的影响。方法 将糖尿病足患者按随机数字表法分为A、B、C组。A组患者给予硫辛酸治疗,B组患者给予PRG治疗,C组给予硫辛酸联合PRG治疗。比较3组糖尿病足患者创面修复情况以及抗凝血酶指标水平。结果 A、B、C组,每组各40例。治疗后,A、B、C组的总有效率分别为42.86%、48.65%和81.82%,C组的总有效率显著高于A组和B组,差异有统计学意义(P<0.05)。治疗后,A组、B组和C组的肉芽组织覆盖率分别为(25.83±4.61)%、(26.17±4.69)%和(29.57±5.12)%,生长厚度分别为(2.70±0.82)、(2.54±0.65)、(3.81±0.79)mm,创面细菌清除率分别为(24.72±5.16)%、(24.13±5.07)%和(30.57±7.13)%,溃疡修复时间分别为(36.72±3.96)、(37.26±4.02)和(27.11±3.65)d,A、B组各指标与C组相比,差异均有统计学意义(均P<0.05)。治疗后,A组、B组和C组的空腹血糖(FBG)分别为(6.85±1.17)、(6.27±1.22)和(5.63±1.06)mmol·L^(-1),餐后2 h血糖(2 h BG)分别为(9.63±2.54)、(9.92±2.61)和(7.45±1.73)mmol·L^(-1),糖化血红蛋白(HbA1c)水平分别为(8.57±1.78)%、(8.73±1.81)%和(7.18±1.24)%,3组患者的FBG、2 h BG、HbA1c水平相较于治疗前有所下降,且C组的FBG、2 h BG、HbA1c均低于A组、B组(均P<0.05),A组与B组差异无统计学意义(P>0.05)。治疗后,A组、B组和C组的肿瘤坏死因子-α(TNF-α)的表达水平分别为(12.83±2.73)、(12.48±2.66)和(9.15±1.82)ng·L^(-1),同型半胱氨酸(Hcy)的表达水平分别为(16.27±4.79)、(15.75±4.30)和(12.36±3.53)μmol·L^(-1),3组患者的TNF-α、Hcy水平均低于治疗前,且C组的TNF-α、Hcy均低于A组、B组(均P<0.05)。3组患者药物不良反应发生率差异无统计学意义(P>0.05)。结论 硫辛酸联合PRG治疗糖尿病足,可以显著增加治疗总有效率,增加组织的再修复能力,降低糖尿病足患者血糖水平以及炎症因子水平,且2种治疗方式联合的安全系�Objective To investigate the effect of lipoic acid combined with autologous platelet-rich gel(PRG) on wound repair and antithrombin in patients with diabetic foot(DF).Methods Patients with diabetic foot were divided into group A,group B and group C according to random number.Group A was administered with lipoic acid,group B was given PRG,group C was administered with lipoic acid combined with PRG.The wound repair and the levels of antithrombin index of diabetic foot patients in three groups were compared.Results There were 40 cases in each group.After treatment,the total efficacy rates of group A,group B and group C were 42.86%,48.65% and 81.82%,respectively,and the total efficacy rate of group C was significantly higher than that of group A and group B,with statistically significant difference(P<0.05).After treatment,the granulation tissue coverage rates in group A,group B and group C were(25.83±4.61)%,(26.17±4.69)% and(29.57±5.12) %;growth thicknesses were(2.70±0.82),(2.54±0.65) and(3.81±0.79)mm;the trauma bacterial clearance rates were(24.72±5.16)%,(24.13±5.07)% and(30.57±7.13)%;the ulcer healing time were(36.72±3.96),(37.26±4.02) and(27.11±3.65) d,the differences of each index in group A and group B compared with those in group C were statistically significant(all P <0.05).After treatment,the fasting blood glucose levels(FBG) in group A,group B and group C were(6.85±1.17),(6.27±1.22) and(5.63±1.06) mmol·L^(-1);the 2-hour postprandial blood glucose(2 h BG) levels were(9.63±2.54),(9.92±2.61) and(7.45±1.73) mmol·L^(-1);the glycosylated hemoglobin levels were(8.57±1.78)%,(8.73±1.81)% and(7.18±1.24)%,the FBG,2 h BG and HbA1c levels in three groups were all decreaced compared with before treatment,group C had lower FBG,2 h BG,and HbA1c levels compared to group A and group B(all P <0.05).However,this difference did not hold statistical significance in group A and group B(P> 0.05).The tumor necrosis factor-α(TNF-α) levels after treatment in group A,group B and group C were(12.83±2.73),(12.48

关 键 词：硫辛酸 自体富血小板凝胶 糖尿病足 创面修复 抗凝血酶 

分 类 号：R97[医药卫生—药品]