摘要
目的 观察糖尿病足患者网膜素-1、血管内皮生长因子(VEGF)水平变化,探讨其与局部高压氧治疗后溃疡创面修复效果的关系。方法 2021年10月—2022年9月海南医学院第二附属医院诊治糖尿病足患者120例,均在胰岛素强化治疗基础上采用局部高压氧治疗足部溃疡创面。治疗2周评价溃疡创面修复效果,计算治愈率,并将患者分为治愈组和未治愈组。比较2组性别、年龄、合并症及高压氧治疗前白细胞计数、血红蛋白、血脂、肝功能、血肌酐、血糖、C反应蛋白水平;分别于治疗前及治疗2周后检测网膜素-1、VEGF水平;绘制ROC曲线,评估治疗前网膜素-1、VEGF预测局部高压氧治疗后糖尿病足创面修复效果的效能;多因素logistic回归分析局部高压氧治疗后糖尿病足创面治愈的影响因素;应用限制性立方样条模型分析治疗前网膜素-1、VEGF与糖尿病足创面未治愈率是否存在非线性相关性。结果 (1)治疗2周治愈25例,显效46例,有效26例,无效23例,治愈率为20.83%,未治愈率为79.17%。(2)治愈组糖尿病病程、糖尿病足病程均短于未治愈组(P<0.05),Wagner 4级比率、空腹血糖、糖化血红蛋白、三酰甘油、总胆固醇、C反应蛋白水平均低于未治愈组(P<0.05),年龄,体质量指数,男性及有吸烟、饮酒史比率,合并高血压、冠心病、脑卒中比率,治疗前白细胞计数、血红蛋白、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、肝功能、血肌酐水平与未治愈组比较差异均无统计学意义(P>0.05)。(3)治愈组、未治愈组治疗2周网膜素-1水平[(151.45±19.76)、(130.76±21.59)μg/L]高于治疗前[(139.34±22.34)、(121.72±20.98)μg/L](t=1.886,P=0.048;t=2.641,P=0.005)、VEGF水平[(90.68±18.34)、(68.32±17.08)ng/L]高于治疗前[(72.06±17.39)、(53.06±16.81)ng/L](t=3.325,P=0.001;t=5.987,P<0.001);治愈组治疗前及治疗2周网膜素-1水平高于未治愈组(t=3.687,P<0.001;t=4.336,P<0.001)、VEGF�
Objective To observe the changes of omentin-1and vascular endothelial growth factor(VEGF)levels in patients with diabetic foot,and to explore their relationships with diabetic foot ulcer healing after local hyperbaric oxygen therapy.Methods A total of 120diabetic foot patients were diagnosed and treated in the Second Affiliated Hospital of Hainan Medical University from October 2021to September 2022.All patients were given local hyperbaric oxygen therapy to treat ulcers in addition to intensive insulin therapy.The healing rate was calculated 2weeks after treatment,and the patients were divided into healing group and nonhealing group.The gender,age,complications,white blood cell count,hemoglobin,blood lipid,liver function,serum creatinine,glucose and C-reactive protein before local hyperbaric oxygen therapy were compared between two groups.The levels of omentin-1and VEGF were detected before and after2-week treatment.ROC curves were drawn to analyze the efficiencies of pretreatment omentin-1and VEGF on evaluating ulcer healing after local hyperbaric oxygen therapy.Multivariate logistic regression analysis was done to assess the influencing factors of ulcer healing after local hyperbaric oxygen therapy.Restricted cubic splines were used to analyze whether there was a non-linear correlation between pretreatment omentin-1and VEGF and the nonhealing rate in diabetic foot patients.Results(1)The 2-week treatment of 120diabetic foot patients showed clinically healing in 25patients,obviously effective in 46,effective in 26and ineffective in 23,with a healing rate of 20.83%and nonhealing rate of79.17%.(2)The durations of diabetes and diabetic foot were shorter in healing group than those in nonhealing group(P<0.05),the Wagner grade 4ratio,and levels of fasting plasma glucose,glycosylated hemoglobin,triacylglycerol,total cholesterol and C-reactive protein were significant lower than those in nonhealing group(P<0.05),and there were no significant differences in the age,body mass index,male ratio,percentages of smoking and dr
作者
王毅
薛芳
林少娜
赖舒畅
陈宗存
WANG Yi;XUE Fang;LIN Shaona;LAI Shuchang;CHEN Zongcun(Department of Endocrinology,the Second Affiliated Hospital of Hainan Medical University,Haikou,Hainan 570311,China)
出处
《中华实用诊断与治疗杂志》
2023年第7期727-732,共6页
Journal of Chinese Practical Diagnosis and Therapy
基金
海南省卫生健康行业科研项目(21A200164,22A200080)。
