富血小板血浆局部注射治疗糖尿病足难愈性溃疡患者的疗效及对患者血清VEGF、HA水平的影响  

Effect of Local Injection of Platelet-Rich Plasma in the Treatment of Diabetic Foot Refractory Ulcer and its Influence on Serum VEGF and HA Levels

作　　者：陈卓 李琰[1] 谢天 CHEN Zhuo;LI Yan;XIE Tian(Department of Wound Repair,The First Affiliated Hospital of Nanyang Medical College,Nanyang Henan 473000)

机构地区：[1]南阳医学高等专科学校第一附属医院创面修复科,河南南阳473000

出　　处：《医学临床研究》2025年第3期419-422,共4页Journal of Clinical Research

摘　　要：【目的】探讨富血小板血浆(platelet-rich plasma,PRP)局部注射治疗糖尿病足难愈性溃疡患者的疗效及对患者血清血管内皮生长因子(vascular endothelial growth factor,VEGF)和透明质酸(hyaluronic acid,HA)水平的影响。【方法】选取2021年8月至2023年11月本院收治的80例糖尿病足难愈性溃疡患者,按照治疗方法不同将患者分为对照组(采用常规治疗方法)和观察组(在对照组基础上采用PRP局部注射治疗),每组40例。比较两组临床疗效、溃疡血流灌注量、细菌定量、溃疡愈合情况(溃疡缩小率、肉芽组织生长厚度、肉芽组织覆盖率、溃疡植皮时间和溃疡愈合时间)、并发症总发生率,治疗前后患足皮肤温度、踝肱指数以及血清VEGF和HA水平。【结果】观察组总有效率、溃疡血流灌注量、溃疡缩小率、肉芽组织覆盖率均高于对照组(P<0.05),细菌定量低于对照组(P<0.05),肉芽组织生长厚度厚于对照组(P<0.05),溃疡植皮时间、溃疡愈合时间短于对照组(P<0.05)。治疗后,观察组患足皮肤温度、踝肱指数及VEGF和HA水平均高于对照组(P<0.05)。两组并发症总发生率比较,差异无统计学意义(P>0.05)。【结论】PRP局部注射治疗糖尿病足难愈性溃疡患者,可显著提高治疗总有效率,缩短溃疡愈合时间,提升血清VEGF和HA水平,且具有较高的安全性,值得临床进一步推广应用。【Objective】To investigate the efficacy of local injection of platelet-rich plasma(PRP)in the treatment of patients with diabetic foot refractory ulcer and its effect on serum vascular endothelial growth factor(VEGF)and hyaluronic acid(HA)levels.【Methods】A total of 80 patients with diabetic foot refractory ulcer admitted to our hospital from August 2021 to November 2023 were selected and divided into control group(conventional treatment)and observation group(PRP local injection treatment on the basis of control group)according to different treatment methods,with 40 cases in each group.The clinical efficacy,blood perfusion volume,bacterial quantification,ulcer healing(ulcer reduction rate,granulation tissue growth thickness,granulation tissue coverage,ulcer skin grafting time and ulcer healing time),total complication rate,skin temperature of affected foot before and after treatment,ankle brachial index and serum VEGF and HA levels were compared between the two groups.【Results】The total effective rate,ulcer blood perfusion volume,ulcer shrinkage rate and granulation tissue coverage rate in observation group were higher than those in control group(P<0.05),and the bacterial quantity in observation group was lower than that in control group(P<0.05).The growth thickness of granulation tissue was higher than that of control group(P<0.05).The time of skin grafting and healing of ulcer were shorter than that of control group(P<0.05).After treatment,the skin temperature,ankle-brachial index,VEGF and HA levels in the observation group were higher than those in the control group(P<0.05).There was no significant difference in the total incidence of complications between the two groups(P>0.05).【Conclusion】Local injection of PRP in the treatment of patients with diabetic foot refractory ulcer can significantly improve the total effective rate,shorten the healing time of ulcer,and enhance the levels of VEGF and HA in serum,and has a high safety,which is worthy of further clinical application.

关 键 词：糖尿病足 富血小板血浆 血管内皮生长因子A 透明质酸 治疗结果 

分 类 号：R587.2[医药卫生—内分泌]