Objective Diabetic foot ulcer(DFU)is one of the most serious complications of diabetes.Leukocyte-and platelet-rich fibrin(L-PRF)is a second-generation autologous platelet-rich plasma.This study aims to investigate the...Objective Diabetic foot ulcer(DFU)is one of the most serious complications of diabetes.Leukocyte-and platelet-rich fibrin(L-PRF)is a second-generation autologous platelet-rich plasma.This study aims to investigate the clinical effects of L-PRF in patients with diabetes in real clinical practice.Methods Patients with DFU who received L-PRF treatment and standard of care(SOC)from 2018 to 2019 in Tongji Hospital were enrolled.The clinical information including patient characteristics,wound evaluation(area,severity,infection,blood supply),SOC of DFU,and images of ulcers was retrospectively extracted and analyzed.L-PRF treatment was performed every 7±2 days until the ulcer exhibited complete epithelialization or an overall percent volume reduction(PVR)greater than 80%.Therapeutic effectiveness,including overall PVR and the overall and weekly healing rates,was evaluated.Results Totally,26 patients with DFU were enrolled,and they had an ulcer duration of 47.0(35.0,72.3)days.The severity and infection of ulcers varied,as indicated by the Site,Ischemia,Neuropathy,Bacterial Infection,and Depth(SINBAD)scores of 2–6,Wagner grades of 1–4,and the Perfusion,Extent,Depth,Infection and Sensation(PEDIS)scores of 2–4.The initial ulcer volume before L-PRF treatment was 4.94(1.50,13.83)cm3,and the final ulcer volume was 0.35(0.03,1.76)cm3.The median number of L-PRF doses was 3(2,5).A total of 11 patients achieved complete epithelialization after the fifth week of treatment,and 19 patients achieved at least an 80%volume reduction after the seventh week.The overall wound-healing rate was 1.47(0.63,3.29)cm3/week,and the healing rate was faster in the first 2 weeks than in the remaining weeks.Concurrent treatment did not change the percentage of complete epithelialization or healing rate.Conclusion Adding L-PRF to SOC significantly improved wound healing in patients with DFU independent of the ankle brachial index,SINBAD score,or Wagner grade,indicating that this method is appropriate for DFU treatment under different clinical con展开更多
目的探讨足背动脉血流量在糖尿病足预后评估中的价值。方法回顾性分析2011年6月至2013年6月于解放军空军总医院住院治疗的662例2型糖尿病患者临床资料,根据是否合并糖尿病足分为非糖尿病足组(n=98)、糖尿病足组(n=564),其中糖尿病足组...目的探讨足背动脉血流量在糖尿病足预后评估中的价值。方法回顾性分析2011年6月至2013年6月于解放军空军总医院住院治疗的662例2型糖尿病患者临床资料,根据是否合并糖尿病足分为非糖尿病足组(n=98)、糖尿病足组(n=564),其中糖尿病足组根据其转归情况分为愈合组(n=218)、好转组(n=280)、不愈合组(n=66)3个亚组,对足背动脉血流量及年龄、性别、糖尿病病程、住院时间、高血压病史、吸烟史进行分析,计量资料中符合正态分布的采用t检验,不符合正态分布的采用秩和检验;计数资料采用χ2检验。结果 4组间患者一般资料的比较发现,性别、高血压史、吸烟史、糖尿病病程差异无统计学意义(P>0.05);年龄、住院时间方面比较,差异有统计学意义(F=2.937、42.630;P=0.033、0.000)。愈合组中位足背动脉血流量为31.0、35.0 m L/min(左侧、右侧),好转组中位足背动脉血流量为30.0、31.0 m L/min(左侧、右侧),不愈合组中位足背动脉血流量为15.0、16.5 m L/min(左侧、右侧),非糖尿病足组中位足背动脉血流量为54.0、63.0 m L/min(左侧、右侧),4组间比较,差异有统计学意义(P=0.000、0.000);愈合组与不愈合组足背动脉血流量(左侧、右侧)比较,差异有统计学意义(Z=1.971、2.250,P=0.007、0.003);与好转组足背动脉血流量(左侧、右侧)比较,差异无统计学意义(Z=1.688、1.788,P=0.276、0.112);糖尿病足愈合的足背动脉血流量需大于等于30 m L/min,如足背动脉血流量小于30 m L/min,则预后差异无统计学意义(P>0.05)。结论足背动脉血流量在评估糖尿病足预后中有重要参考价值,可辅助临床选择合适的治疗方法。展开更多
目的探讨红细胞体积分布宽度(RDW)和中性粒细胞与淋巴细胞比(NLR)联合预测糖尿病足预后的价值。方法收集新疆医科大学第一附属医院2017年1月至2019年12月在血管甲状腺外科住院行截肢手术的糖尿病足100例患者的临床资料进行回顾性分析。...目的探讨红细胞体积分布宽度(RDW)和中性粒细胞与淋巴细胞比(NLR)联合预测糖尿病足预后的价值。方法收集新疆医科大学第一附属医院2017年1月至2019年12月在血管甲状腺外科住院行截肢手术的糖尿病足100例患者的临床资料进行回顾性分析。按截肢平面分为大截肢组(踝关节以上,n=50)和小截肢组(踝关节及以下,n=50),分析术前NLR和RDW对截肢手术平面的预测效能。结果大截肢组患者术前NLR(9.81±2.09 vs 6.95±3.25,P<0.01)和RDW(14.02±2.87 vs 12.94±1.96,P<0.05)显著高于小截肢组。Logistic回归分析显示,术前高NLR和RDW水平是糖尿病足患者大截肢的独立危险因素(P<0.05)。ROC曲线分析显示,联合检测糖尿病足大截肢的AUC(0.79)大于NLR和RDW单项检测(0.77和0.59),敏感度、特异度(70.1%、71.8%)高于NLR和RDW单项检测(69.1%、68.3%和60.1%、61.2%)。结论糖尿病足患者术前NLR和RDW越高,行大截肢手术的可能性越大。术前NLR和RDW可能可以作为预测糖尿病足患者预后的指标。展开更多
基金supported by grants from the National Natural Science Foundation of China(No.81100581)the Bethune Merck Diabetes Research Fund(No.2018)+1 种基金the Fund of the Sichuan Provincial Western Psychiatric Association's CSPC LEADING Scientific Research Project(No.WL2021104)the China International Medical Foundation-Senmei China Diabetes Research Fund(No.Z-2017-26-1902-5).
文摘Objective Diabetic foot ulcer(DFU)is one of the most serious complications of diabetes.Leukocyte-and platelet-rich fibrin(L-PRF)is a second-generation autologous platelet-rich plasma.This study aims to investigate the clinical effects of L-PRF in patients with diabetes in real clinical practice.Methods Patients with DFU who received L-PRF treatment and standard of care(SOC)from 2018 to 2019 in Tongji Hospital were enrolled.The clinical information including patient characteristics,wound evaluation(area,severity,infection,blood supply),SOC of DFU,and images of ulcers was retrospectively extracted and analyzed.L-PRF treatment was performed every 7±2 days until the ulcer exhibited complete epithelialization or an overall percent volume reduction(PVR)greater than 80%.Therapeutic effectiveness,including overall PVR and the overall and weekly healing rates,was evaluated.Results Totally,26 patients with DFU were enrolled,and they had an ulcer duration of 47.0(35.0,72.3)days.The severity and infection of ulcers varied,as indicated by the Site,Ischemia,Neuropathy,Bacterial Infection,and Depth(SINBAD)scores of 2–6,Wagner grades of 1–4,and the Perfusion,Extent,Depth,Infection and Sensation(PEDIS)scores of 2–4.The initial ulcer volume before L-PRF treatment was 4.94(1.50,13.83)cm3,and the final ulcer volume was 0.35(0.03,1.76)cm3.The median number of L-PRF doses was 3(2,5).A total of 11 patients achieved complete epithelialization after the fifth week of treatment,and 19 patients achieved at least an 80%volume reduction after the seventh week.The overall wound-healing rate was 1.47(0.63,3.29)cm3/week,and the healing rate was faster in the first 2 weeks than in the remaining weeks.Concurrent treatment did not change the percentage of complete epithelialization or healing rate.Conclusion Adding L-PRF to SOC significantly improved wound healing in patients with DFU independent of the ankle brachial index,SINBAD score,or Wagner grade,indicating that this method is appropriate for DFU treatment under different clinical con
文摘目的探讨足背动脉血流量在糖尿病足预后评估中的价值。方法回顾性分析2011年6月至2013年6月于解放军空军总医院住院治疗的662例2型糖尿病患者临床资料,根据是否合并糖尿病足分为非糖尿病足组(n=98)、糖尿病足组(n=564),其中糖尿病足组根据其转归情况分为愈合组(n=218)、好转组(n=280)、不愈合组(n=66)3个亚组,对足背动脉血流量及年龄、性别、糖尿病病程、住院时间、高血压病史、吸烟史进行分析,计量资料中符合正态分布的采用t检验,不符合正态分布的采用秩和检验;计数资料采用χ2检验。结果 4组间患者一般资料的比较发现,性别、高血压史、吸烟史、糖尿病病程差异无统计学意义(P>0.05);年龄、住院时间方面比较,差异有统计学意义(F=2.937、42.630;P=0.033、0.000)。愈合组中位足背动脉血流量为31.0、35.0 m L/min(左侧、右侧),好转组中位足背动脉血流量为30.0、31.0 m L/min(左侧、右侧),不愈合组中位足背动脉血流量为15.0、16.5 m L/min(左侧、右侧),非糖尿病足组中位足背动脉血流量为54.0、63.0 m L/min(左侧、右侧),4组间比较,差异有统计学意义(P=0.000、0.000);愈合组与不愈合组足背动脉血流量(左侧、右侧)比较,差异有统计学意义(Z=1.971、2.250,P=0.007、0.003);与好转组足背动脉血流量(左侧、右侧)比较,差异无统计学意义(Z=1.688、1.788,P=0.276、0.112);糖尿病足愈合的足背动脉血流量需大于等于30 m L/min,如足背动脉血流量小于30 m L/min,则预后差异无统计学意义(P>0.05)。结论足背动脉血流量在评估糖尿病足预后中有重要参考价值,可辅助临床选择合适的治疗方法。
文摘目的探讨红细胞体积分布宽度(RDW)和中性粒细胞与淋巴细胞比(NLR)联合预测糖尿病足预后的价值。方法收集新疆医科大学第一附属医院2017年1月至2019年12月在血管甲状腺外科住院行截肢手术的糖尿病足100例患者的临床资料进行回顾性分析。按截肢平面分为大截肢组(踝关节以上,n=50)和小截肢组(踝关节及以下,n=50),分析术前NLR和RDW对截肢手术平面的预测效能。结果大截肢组患者术前NLR(9.81±2.09 vs 6.95±3.25,P<0.01)和RDW(14.02±2.87 vs 12.94±1.96,P<0.05)显著高于小截肢组。Logistic回归分析显示,术前高NLR和RDW水平是糖尿病足患者大截肢的独立危险因素(P<0.05)。ROC曲线分析显示,联合检测糖尿病足大截肢的AUC(0.79)大于NLR和RDW单项检测(0.77和0.59),敏感度、特异度(70.1%、71.8%)高于NLR和RDW单项检测(69.1%、68.3%和60.1%、61.2%)。结论糖尿病足患者术前NLR和RDW越高,行大截肢手术的可能性越大。术前NLR和RDW可能可以作为预测糖尿病足患者预后的指标。
