| 王小飞,高素文,张贞.脐带间充质干细胞移植联合负压封闭引流技术治疗糖尿病足溃疡的疗效观察[J].安徽医药,2024,28(4):777-781. |
| 脐带间充质干细胞移植联合负压封闭引流技术治疗糖尿病足溃疡的疗效观察 |
| The curative effect of umbilical cord mesenchymal stem cells transplantation combined with vacuum sealing drainage for diabetic foot ulcer |
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| DOI：10.3969/j.issn.1009-6469.2024.04.030 |
| 中文关键词: 糖尿病足 溃疡 负压封闭引流技术 脐带间充质干细胞 疗效 |
| 英文关键词: Diabetic foot Ulcer Vacuum sealing drainage Umbilical cord mesenchymal stem cells Curative effect |
| 基金项目:邯郸市科学技术研究与发展计划项目( 21422083135) |
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| 中文摘要: |
| 目的观察脐带间充质干细胞移植( UCMSCs)联合负压封闭引流技术( VSD)治疗糖尿病足溃疡( DFU)的疗效。方法纳入 2020年 5月至 2022年 5月邯郸市中心医院收治的 86例 DFU病人，根据随机数字表法分为引流组( 43例)和联合组( 43例)。其中引流组给予 VSD，联合组给予 UCMSCs联合 VSD。比较两组创面愈合时间及创面愈合率，足部相关指标［足背动脉血管内径、血流速度、踝肱指数( ABI)］，周围血管恢复情况［密歇根神经体征评分( MNSI)、 CT血管造影( CTA)检查］，炎症指标［C反应蛋白(CRP)、白细胞( WBC)中性粒细胞百分比(NEU%)］，肾功能(尿酸、肌酐)及临床疗效。结果联合组创面愈合率［(68.42±6.95)%比( 52.78±5.35)%］明、显高于引流组(P<0.05)，创面愈合时间［(27.34±2.76)d比( 31.46±3.25)d］明显低于引流组(P<0.05)；引流组和联合组治疗后足背动脉血管内径［( 1.95±0.21)mm比( 1.86±0.17)mm，(2.10±0.35)mm比( 1.82±0.15)mm］、 ABI(0.87±0.26比 0.61±0.15，0.75±0.21比 0.64±0.17)均明显升高( P<0.05)且与引流组比较，联合组明显升高( P<0.05)；与治疗前比较，引流组和联合组治疗后足背动脉血流速度［( 47.35±4.75)cm/s比(，52.75±5.32)cm/s，(41.78±4.27)cm/s比( 52.14±5.26) cm/s］、 MNSI评分( 4.68±0.51比 5.74±0.61，4.12±0.42比 5.89±0.65)、 CRP［( 35.78±3.62)mg/L比( 41.78±4.25)mg/L，(29.36±3.02) mg/L比( 2.14±4.31)mg/L］、 WBC［( 7.58±0.79)×109/L比( 9.45±1.06)×109/L，(6.42±0.67)×109/L比( 9.12±1.01)×109/L］、 NEU%［( 64.31±6.53)%比( 69.72±7.02)%，(58.14±5.86)%比( 70.54±7.11)%］水平均明显降低( P<0.05)且与引流组比较，联合组明显降低( P<0.05)；联合组总有效率( 95.35%)明显高于引流组( 72.09%)，联合组临床疗效优于引流，组( Z=2.09，P<0.05)。结论 UCMSCs联合 VSD治疗 DFU可有效减轻炎症反应，改善临床症状，促进创面恢复，效果较好。 |
| 英文摘要: |
| Objective To observe the efficacy of umbilical cord mesenchymal stem cells (UCMSCs) transplantation combined withvacuum sealing drainage (VSD) for diabetic foot ulcer (DFU).Methods Eighty-six DFU patients admitted to Handan Central Hospital from May 2020 to May 2022 were randomly assigned into a drainage group (n=43) and a combination group (n=43) using a random num?ber table method. The drainage group was given VSD, while the combination group was given UCMSCs combined with VSD. A compari?son was made of the wound healing time and wound healing rate, foot-related indicators [inner diameter of the dorsal foot artery, blood flow velocity, ankle-brachial index (ABI)], peripheral blood vessel recovery [Michigan Neuropathy Screening Instrument (MNSI), CT an?giography (CTA)], inflammatory indicators [C-reactive protein (CRP), white blood cells (WBC), percentage of neutrophils (NEU%)], re?nal function (uric acid, creatinine) and clinical efficacy between the two groups.Results The wound healing rate of the combination group [(68.42±6.95)% vs. (52.78±5.35)% )] was significantly higher than that of the drainage group (P<0.05), and the wound healing time [(27.34±2.76) d vs. (31.46±3.25) d] was significantly lower than that of the drainage group (P<0.05). After treatment, the inner di? ameters of the dorsal foot artery [(1.95±0.21) mm vs. (1.86±0.17) mm, (2.10±0.35) mm vs. (1.82±0.15) mm] and ABI (0.87±0.26 vs. 0.61±0.15, 0.75±0.21 vs. 0.64±0.17) were significantly increased in both the drainage group and the combination group (P<0.05), and compared with the drainage group, the combination group showed a more significant increase (P<0.05). Compared with pretreatment, the posttreatment blood flow velocity of the dorsal foot artery [(47.35±4.75) cm/s vs. (52.75±5.32) cm/s, (41.78±4.27) cm/s vs. (52.14± 5.26) cm/s], MNSI score (4.68±0.51 vs. 5.74 ±0.61, 4.12±0.42 vs. 5.89±0.65), CRP [(35.78±3.62) mg/L vs. (41.78±4.25) mg/L, (29.36± 3.02) mg/L vs. (2.14±4.31) mg/L], and WBC [(7.58±0.79) ×109/L vs. (9.45±1.06) ×109/L, (6.42± 0.67) × 109/L vs. (9.12±1.01) × 109/L], NEU% [(64.31±6.53) % vs. (69.72±7.02) %, (58.14± 5.86) % vs. (70.54±7.11) %] in both groups were significantly reduced (P<0.05), and compared with the drainage group, the combination group showed a more significant decrease (P<0.05). The total effective rate ofthe combination group (95.35%) was significantly higher than that of the drainage group (72.09%), and the clinical efficacy of the com?bination group was better than that of the drainage group (Z=2.09, P<0.05).Conclusion UCMSCs combined with VSD for DFU can ef? fectively reduce inflammation, ameliorate clinical symptoms, and promote wound recovery, which achieves better effect. |
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