Steed D L, Goslen J B, Holloway G A, Malone J M, Bunt T J, Webster M W
Department of Surgery, University of Pittsburgh, School of Medicine, Pennsylvania.
Diabetes Care. 1992 Nov;15(11):1598-604. doi: 10.2337/diacare.15.11.1598.
To assess the efficacy of topically applied CT-102 APST for treating diabetic neurotrophic foot ulcers.
Thirteen patients entered a randomized, double-blind trial of topically applied CT-102 APST vs. placebo (normal saline) gauze dressings for the treatment of nonhealing diabetic neurotrophic foot ulcers. CT-102 APST (Curative Technologies, Setauket, NY) was prepared from homologous platelets and contained multiple growth factors including PDGF, PDAF, EGF, PF-4, TGF-beta, aFGF, and bFGF. Inclusion criteria for subjects included diabetes, ulcer of > 8 wk duration, peri-wound transcutaneous oxygen tension > 30 mmHg, platelet count > 100,000/mm3, and no wound infection. Wounds were excised before entry and were > 700 mm3 but < 50,000 mm3 in volume, < 100 cm2 in area, and involved subcutaneous tissue.
In the CT-102 group, 5 of 7 ulcers were healed (100% epithelialized) by 15 wk, but only 1 of 6 ulcers was healed by 20 wk with placebo (P < 0.05). Average percent reduction in ulcer area at 20 wk was 94% for CT-102 vs. 73% for placebo. Daily reduction in ulcer volume was 73.8 +/- 42.4 mm3/day (mean +/- SE) for CT-102 vs. 21.8 +/- 8.1 mm3/day for placebo (P < 0.05). Daily reduction in ulcer area was 6.2 +/- 1.8 mm2/day for CT-102 vs. 1.8 +/- 0.4 mm2/day for placebo (P < 0.05).
CT-102 significantly accelerated wound closure in diabetic leg ulcers when administered as part of a comprehensive program for the healing of chronic ulcers.
评估局部应用CT - 102 APST治疗糖尿病性神经营养性足部溃疡的疗效。
13例患者进入一项随机双盲试验,比较局部应用CT - 102 APST与安慰剂(生理盐水)纱布敷料治疗不愈合的糖尿病性神经营养性足部溃疡的效果。CT - 102 APST(Curative Technologies公司,纽约州塞托凯特)由同源血小板制备而成,含有多种生长因子,包括血小板衍生生长因子(PDGF)、血小板衍生促血管生成因子(PDAF)、表皮生长因子(EGF)、血小板因子4(PF - 4)、转化生长因子β(TGF - β)、酸性成纤维细胞生长因子(aFGF)和碱性成纤维细胞生长因子(bFGF)。受试者的纳入标准包括患有糖尿病、溃疡持续时间超过8周、伤口周围经皮氧分压>30 mmHg、血小板计数>100,000/mm³,且无伤口感染。在入组前对伤口进行清创,伤口体积>700 mm³但<50,000 mm³,面积<100 cm²,且累及皮下组织。
在CT - 102组中,7例溃疡中有5例在15周时愈合(100%上皮化),而安慰剂组6例溃疡中只有1例在20周时愈合(P<0.05)。CT - 10²组在20周时溃疡面积平均减少百分比为94%,而安慰剂组为73%。CT - 102组溃疡体积每日减少73.8±42.4 mm³/天(均值±标准误),安慰剂组为21.8±8.1 mm³/天(P<0.05)。CT - 102组溃疡面积每日减少6.2±1.8 mm²/天,安慰剂组为1.8±0.4 mm²/天(P<0.05)。
当作为慢性溃疡愈合综合方案的一部分给药时,CT - 102可显著加速糖尿病腿部溃疡的伤口愈合。