重组人粒细胞-巨噬细胞集落刺激因子治疗早期糖尿病足溃疡疗效观察

目的:观察局部皮下注射重组人粒细胞-巨噬细胞集落刺激因子(rhGM-CSF)治疗糖尿病足溃疡患者的疗效。方法:36例糖尿病足溃疡1～3级患者均用胰岛素强化控制血糖在理想范围内,溃疡面先用强力碘清洁消毒处理,再用生理盐水冲洗,清除坏死组织,第2次用生理盐水冲洗,然后随机分为2组。治疗组:直接将rhGM-CSF注射剂按5μg.kg-1.d-1沿创面周围皮下注射,每日1次;对照组:常规消毒清洁创面后,用无菌凡士林纱布覆盖溃疡面,每天换药1次,2组均治疗30d。结果:治疗组与对照组的总有效率分别为100.0%、83.3%(P<0.05);平均住院时间分别为21、32d(P<0.05)。结论:rhGM-CSF局部皮下注射较常规换药可提高糖尿病足溃疡1～3级患者的总有效率,促进糖尿病足慢性创面的愈合。

Efficacy Observation of Recombinant Human Granulocyte Macrophage-colony Stimulating Factor for Early Diabetic Foot Ulcers

OBJECTIVE： To observe curative efficacy of local subcutaneous injection of recombinant human granulocyte macro- phage-colony stimulating factor （rhGM-CSF） in the treatment of early diabetic foot ulcers. METHODS： Blood glucose of 36 pa- tients with diabetic foot ulcers at 1~3 levels were controlled ideally by intensive insulin therapy. Surface of the ulcer was disinfect- ed with iodophor and rinsed with normal saline, and necrosis tissues were cleared away. The surface of the ulcer was rinsed with normal saline at the second time. Then they were divided into 2 groups randomly. Treatment group： rhGM-CSF was subcutaneous injected directly around the ulcer at.dose of 5 μg·kg^-1·d^-1 once a day. Control group： the surface of ulcer was disinfected regularly and covered with an asepsis vaseline carbasus, the dressing was changed once a day. Both groups lasted for 30 days. RESULTS： The total effective rates of treatment group and control group were 100.0% and 83.3% （P〈0.05）. Average admission days were 21 days and 32 days（P〈0.05）. CONCLUSION： Overall response rate of diabetic foot ulcers at 1-3 levels and the healing of chronic wound of diabetic foot have been improved by local subcutaneous injection of rhGM-CSF.