胫骨横向骨搬移对血清血管生成相关因子表达的影响

目的探讨胫骨横向骨搬移术对糖尿病足患者血清中血管生成相关因子表达的影响。方法回顾分析2018年1月-12月收治的10例Wagner 4期糖尿病足患者临床资料,男5例,女5例;年龄51~70岁,平均59.2岁。糖尿病病程2~60个月,平均24.2个月;糖尿病足病程30~120 d,平均54.1 d。分别于术前1 d及术后1、4、11、18、28、35 d抽取外周静脉血,离心取血清采用ELISA法检测血管生成相关因子VEGF、bFGF、EGF、PDGF的表达水平。结果患者血清VEGF、bFGF及EGF表达水平均在术后11 d突然升高,11、18、28、35 d各因子表达水平均显著高于术前,差异有统计学意义(P<0.05);PDGF表达水平于术后18 d突然升高,18、28、35 d PDGF表达水平显著高于术前,差异有统计学意义(P<0.05)。结论胫骨横向骨搬移术治疗糖尿病足,早期可显著增加血清血管生成相关因子的表达,可能是其促进糖尿病足创面愈合的作用机制。

Effect of transverse tibial bone transport on expression of serum angiogenesis-related growth factors

Objective To investigate the effect of transverse tibial bone transport on the expression of angiogenesis-related growth factors in the serum of diabetic foot patients. Methods Between January 2018 and December 2018, 10 patients who suffered from diabetes mellitus accompanied with Wagner stage 4 diabetic foot underwent transverse tibial bone transport. There were 5 males and 5 females with an average age of 59.2 years(range, 51-70 years). The duration of diabetes was 2-60 months, with an average of 24.2 months. The duration of diabetic foot was 30-120 days, with an average of 54.1 days. Peripheral venous blood was taken at 1 day before operation and at 1, 4, 11, 18, 28,and 35 days after operation. The serum was centrifuged and subjected to ELISA test to detect the expression levels of serum vascular endothelial growth factor(VEGF), basic fibroblast growth factor(bFGF), epidermal growth factor(EGF),and platelet-derived growth factor(PDGF). Results The levels of serum VEGF, bFGF, and EGF increased rapidly at 11 days after operation, and the expression levels of the factors at 11, 18, 28, and 35 days were significantly higher than those before operation(P<0.05). The expression level of PDGF increased suddenly at 18 days after operation, and the expression level of PDGF at 18, 28, and 35 days was significantly higher than that before operation(P<0.05). Conclusion Transverse tibial bone transport for the treatment of diabetic foot can significantly increase the expression of serum angiogenesisrelated growth factors in early stage, which may be the mechanism of promoting the healing of diabetic foot wounds.