自体血小板凝胶在糖尿病足溃疡治疗中的应用研究

目的 观察自体富血小板凝胶治疗糖尿病足溃疡（DFU）的疗效. 方法 72例DFU患者按照数字随机法分为两组.治疗组采用自体富血小板凝胶外敷;对照组采用常规疗法.比较两组DFU治愈率、好转率及愈合时间. 结果 两组间年龄、糖尿病病程、FPG、FIns、HbA1c、稳态模型评估胰岛素抵抗指数（HOMA-IR）、BMI、TG、TC、LDL-C、HDL-C、溃疡面积及溃疡体积比较差异均无统计学意义（P＞0.05）.两组Wagner Ⅰ级DFU治疗的疗效比较差异均无统计学意义（P＞0.05）.在WagnerⅡ、Ⅲ级DFU病例中,治疗组治愈率（66.7％、70.0％）、总有效率（94.4％、90.0％）均高于对照组（治愈率：26.3％、57.9％;总有效率：10.0％、30.0％）（P＜0.05）;治疗组Wagner Ⅰ～Ⅲ级DFU愈合时间均短于对照组[WagnerⅠ级：（14.75±1.82） vs （22.00±1.63）d;WagnerⅡ级：（27.12±2.15） vs （34.93±1.44）d;WagnerⅢ级：（41.89±3.22） vs （53.83±1.17）d] （P＜0.05）. 结论 自体富血小板凝胶可能具有促进DFU愈合的作用.

The application of autologous platelet-rich gel in the treatment of diabetic foot ulcers

Objective To evaluate the efficacy of autologous platelevrich gel （APG） in the treatment of diabetic foot ulcers. Methods 72 patients with diabetic foot ulcers patients accepted eficacy observation,physical examination and blood sample detection. All the 72 patients were random classified into two groups： autologous platelet rich gel treatment group and control group, to compare the recovery rate,effective rate and recovery time of DFU between the two groups. Results The age, diabetes duration, FPG, Fins, HbA1 c, the homeostasis model assessment of insulin resistance index （HOMA IR）, BMI, TG, TC, LDLC, HDLC, area and volume of ulcer showed no significant differences betweent the two groups（P〉0.05）. All the Wagner I patients in APG treatment group, while only 6 patients were cured in control group. The numbers of Wagner Ⅱ patients cured in APG treatment group and control group were 12 and 5,respectively. Five Wagner Ⅱ patients were found to get better in APG treatment group, and 10 patients in control group improved. For Wagner Ⅲ, 7 patients in APG treatment group, and only 1 in control group, were cured. Both APG treatment group and control group had two improved Wagner Ⅲ patients improved. Treatment group the for Wagner Ⅱ ～ Ⅲ patients, the recovery rate and effective rate of diabetic foot ulcers in APG treatment group（recovery rate were 66.7% and 70.0%;Effeetive rate were 94.4% and 90.0%） are significantly greater than control group（26.3%, 57.9%; 10.0%, 30.0%） （P〈 0.05）. There is no significant difference in Wagner I patients （P〉 0.05）. The analysis of chi-square showed that recovery time and effective time of Wagner I ～ Ⅲ DFU patients in APG treatment group are significantly shorter than control group[WagnerI： （14. 75 ± 1 2. 15） vs （34.93±1.44） d;WagnerⅢ ： （41.89±3.22） vs Autologous platelet-rich gel plays an important role in the 82） vs （22.00± 1.63） d;Wagner Ⅱ ： （27.122.15） vs （34.93±1.44）d;WagnerⅢ：（41.89±3.2