胫骨横向骨搬移治疗糖尿病足的机制研究  

The mechanism of transverse tibial transfer in the treatment of diabetic foot

作　　者：陈子豪 黎立[1] 艾尔肯·热合木吐拉 司裕[1] 周泓宇[1] 李靖扬[1] CHEN Zihao;LI Li;AIERKEN·Rehemutula;SI Yu;ZHOU Hongyu;LI Jingyang(Department of Orthopedics,Affiliated Hospital of Traditional Chinese Medicine of Xinjiang Medical University,Urumqi,Xinjiang 830000,China)

机构地区：[1]新疆医科大学附属中医医院骨五科,乌鲁木齐830000

出　　处：《重庆医学》2024年第3期381-386,393,共7页Chongqing medicine

基　　金：新疆维吾尔自治区自然科学基金项目(2021D01C212)。

摘　　要：目的探讨胫骨横向骨搬移(TTT)治疗糖尿病足(DF)的作用机制。方法选取2021-2022年于该院治疗的63例DF患者为研究对象,分为试验组(33例)和对照组(30例)。试验组行TTT治疗,对照组行常规保守治疗。治疗前后分别收集患者外周血并分离单个核细胞,采用多色流式细胞术检测T细胞亚群指标变化,Western blot检测基质细胞衍生因子-1(SDF-1)及其趋化因子受体(CXCR4),以及磷脂酰肌醇3激酶(PI3K)/蛋白激酶B(Akt)信号通路相关蛋白表达水平。结果试验组的总有效率(93.94%)明显高于对照组(73.33%),差异有统计学意义(P<0.05)。治疗后试验组CD3^(+)、CD4^(+)及CD4^(+)/CD8^(+)水平均高于对照组,CD8^(+)水平低于对照组,SDF-1、CXCR4、p-PI3K、p-Akt蛋白表达水平均高于对照组,差异有统计学意义(P<0.05)。结论上调SDF-1/CXCR4信号轴激活PI3K/Akt信号通路可能是TTT治疗DF的机制之一。Objective To investigate the mechanism of transverse tibial transfer(TTT)in the treatment of diabetic foot(DF).Methods A total of 63 DF patients treated in our hospital from 2021 to 2022 were selected as the research objects and divided into the experimental group(33 cases)and the control group(30 cases).The experimental group was treated with TTT,and the control group was treated with conventional conservative treatment.Multicolor flow cytometry was used to detect the changes of T lymphocyte subsets.Western blot was used to detect the expression levels of stromal cell-derived factor-1(SDF-1),chemokine receptor(CXCR4)and phosphatidylinositol 3 kinase(PI3K)/protein kinase B(Akt)signaling pathway-related proteins.Results The total effective rate of the experimental group was 93.94%,which was significantly higher than that of the control group 73.33%,the difference was statistically significant(P<0.05).After treatment,CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)in experimental group were higher than those in control group,and CD8^(+)was lower than that in the control group,the differences were statistically significant(P<0.05).The protein expression levels of SDF-1,CXCR4,p-PI3K and p-Akt were higher than those in the control group,and the differences were statistically significant(P<0.05).Conclusion The activation of PI3K/Akt signaling pathway by up-regulating SDF-1/CXCR4 signaling axis may be one of the mechanisms of TTT in the treatment of DF.

关 键 词：糖尿病足 胫骨横向骨搬移 SDF-1/CXCR4信号轴 PI3K/AKT信号通路 

分 类 号：R687.35[医药卫生—骨科学]