前列地尔辅助硫辛酸治疗糖尿病足溃疡合并感染的临床效果

目的探讨前列地尔辅助硫辛酸治疗糖尿病足溃疡合并感染对患者胰岛素样生长因子-1(IGF-1)、纤维连接蛋白(FN)、血管内皮生长因子(VEGF)水平及足背血流动力学的影响。方法选取2017年5月-2019年5月新疆医科大学第一附属医院收治的104例糖尿病足溃疡合并感染患者,采用随机数字表法将所选患者分为研究组(n=52)和对照组(n=52)。对照组给予硫辛酸进行治疗,研究组在此基础上给予前列地尔进行治疗,两组均治疗4周。比较两组治疗4周后的下肢静息疼痛改善情况,治疗前、治疗4周后的血清IGF-1、FN、VEGF水平及足背动脉血流速度和足背动脉内径,统计两组治疗期间的不良反应发生率。结果治疗4周后,研究组下肢静息疼痛总改善率为96.15%,高于对照组(P<0.05)。与治疗前比,治疗4周后,两组血清IGF-1、FN、VEGF水平及足背动脉血流速度、足背动脉内径均升高,且研究组均高于对照组(P<0.05)。治疗期间,研究组不良反应发生率为5.77%,低于对照组(P<0.05)。结论前列地尔辅助硫辛酸治疗糖尿病足溃疡合并感染,可显著提高患者血清IGF-1、FN、VEGF水平,改善其足背血流动力学,并能缓解患者下肢静息疼痛,降低不良反应发生率。

Clinical effect of lipoic acid combined with alprostadil on treatment of diabetic foot ulcer patients complicated with infection

OBJECTIVE To explore the effect of lipoic acid combined with alprostadil on treatment of diabetic foot ulcer patients complicated with infection and observe the influence on levels of insulin-like growth factor-1(IGF-1),fibronectin(FN),vascular endothelial growth factor(VEGF)as well as dorsal foot hemodynamics.METHODS A total of 104 diabetic foot ulcer patients complicated with infection who were treated in the First Affiliated Hospital of Xinjiang Medical University from May 2017 to May 2019 were enrolled in the study and randomly divided into the study group with 52 cases and the control group with 52 cases.The control group was treated with lipoic acid,while the study group was given additional alprostadil on the basis of the treatment of the control group,both groups were treated for 4 weeks.The improvement of resting pain in lower limbs was compared between the two groups after the treatment for 4 weeks,the levels of serum IGF-1,FN and VEGF,blood flow velocity and the inner diameter of the dorsal foot artery were observed and compared before the treatment and after the treatment for 4 weeks,and the incidence rates of adverse reactions were statistically analyzed during the treatment.RESULTS The total improvement rate of lower limb resting pain of the study group was 96.15%after the treatment for 4 weeks,significantly higher than that of the control group(P<0.05).The levels of serum IGF-1,FN and VEGF,dorsal plantar artery blood flow velocity and dorsal plantar artery diameter of the two groups were significantly higher after the treatment for 4 weeks than before the treatment,and the levels of above indexes of the study group were significantly higher than those of the control group(P<0.05).The incidence of adverse reactions of the study group was 5.77%during the treatment,significantly lower than that of the control group(P<0.05).CONCLUSION Lipoic acid combined with alprostadil can significantly raise the levels of serum IGF-1,FN and VEGF of the diabetic foot ulcer patients complicated with infection,improve the dorsal foot hemodynamics,relieve the lower limb resting pain,and reduce the incidence of adverse reactions.