自体富血小板凝胶联合噻吗洛尔对糖尿病足溃疡术后的临床研究OA

Objective To observe the clinical efficacy and safety of autologous platelet-rich gel(APG)combined with timolol eye drops in postoperative patients with diabetic foot ulcer.Methods Patients with diabetic foot ulcers who were admitted to the department of endocrinology of our hospital and underwent surgical treatment were divided into control group and treatment group based on postoperative intervention protocols.In control group,wounds were cleaned and disinfected,then evenly covered with 0.5-1.0 cm thick APG,dressed with petrolatum gauze and sterile gauze once weekly for 4 weeks.The treatment group received the same APG treatment combined with timolol maleate eye drops(one drop per square centimeter of wound surface dripped on the inner gauze over APG);dressing was applied after absorption,administered once every two days for 4 weeks.Compare the clinical efficacy,wound progress,serum inflammatory markers,angiogenesis indicators,wound collagen,blood flow in the dorsalis pedis artery and safety between the two groups.Results This research included 80 participants,among whom 42 were allocated to control group and 38 to treatment group.After treatment,the treatment group achieved a total clinical efficacy rate of 86.84％(33 cases/38 cases),this outcome was markedly superior to the control group's 66.67％(28 cases/42 cases),and the inter-group difference was statistical significance(P＜0.05).After treatment,the wound area in treatment group and control group were(5.96±1.56)and(6.86±1.84)cm2,respectively;wound depth were(0.56±0.08)and(0.62±0.13)cm,respectively;wound symptom scores(TIME)were(3.84±0.79)and(4.26±0.96)points,respectively;wound healing time was(57.18±9.52)and(64.26±11.37)days,respectively;the serum omentin-1 levels were(899.04±86.77)and(853.56±80.25)ng·L-1,respectively;the intercellular adhesion molecule-1(ICAM-1)levels were(211.03±31.73)and(230.25±36.92)μg·L-1,respectively;the endostatin levels were(38.84±4.73)and(42.05±5.29)ng·L-1,respectively;the vascular endothelial growth factor(VEGF)levels were(100.60±12.11)and(93.93±9.92)ng·mL-1,respectively;the platelet-derived growth factor(PDGF)levels were(85.58±9.15)and(80.50±8.13)ng·mL-1,respectively;the basic fibroblast growth factor(bFGF)levels were(84.33±12.26)and(78.16±10.64)ng·mL-1,respectively;the type Ⅰ collagen levels were(2.77±0.70)and(2.36±0.63)mg·mL-1,respectively;the type Ⅲ collagen levels were(2.52±0.75)and(2.09±0.62)mg·mL-1,respectively;dorsalis pedis artery inner diameter were(2.03±0.33)and(1.85±0.29)mm,respectively;peak flow velocity were(0.79±0.17)and(0.68±0.15)m·s-1,respectively;blood flow were(21.55±4.30)and(19.38±3.89)mL·min-1,respectively.The differences of the above indicators between the two groups were all statistically significant(P＜0.05,P＜0.01).Regarding adverse drug reactions,the treatment group had local pruritus,local dryness and mild stinging;the control group had mild local irritation,and mild redness and swelling.The total incidence of adverse drug reactions in treatment group and control group were 7.89％(3 cases/38 cases)and 7.14％(3 cases/42 cases),respectively,with no statistically significant difference between the two groups(P＞0.05).Conclusion For patients with diabetic foot ulcers following surgery,the combination therapy of APG and timolol eye drops demonstrates definite clinical efficacy.It effectively promotes wound healing,shortens healing time,alleviates inflammatory responses,enhances angiogenesis and collagen deposition in the wound,and contributes to the improvement of pedal blood supply,all with a favorable safety profile.