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基层医疗中自体富血小板血浆治疗血管性溃疡的疗效与安全性:III期研究。

Efficacy and safety of autologous platelet rich plasma for the treatment of vascular ulcers in primary care: Phase III study.

作者信息

San Sebastian Kepa M, Lobato Igone, Hernández Igone, Burgos-Alonso Natalia, Gomez-Fernandez Maria Cruz, López Jose Luis, Rodríguez Begoña, March Anna Giné, Grandes Gonzalo, Andia Isabel

机构信息

Ezkerraldea-Enkarterri Health Region, Basque Health Service (Osakidetza), Portugalete, Spain.

Primary Care Research Unit of Bizkaia, BioCruces Health Research Institute, Osakidetza, Luis Power 18, planta 4; E-48014, Bilbao, Spain.

出版信息

BMC Fam Pract. 2014 Dec 30;15:211. doi: 10.1186/s12875-014-0211-8.

Abstract

BACKGROUND

Vascular ulcers are commonly seen in daily practice at all levels of care and have great impact at personal, professional and social levels with a high cost in terms of human and material resources. Given that the application of autologous platelet rich plasma has been shown to decrease healing times in various different studies in the hospital setting, we considered that it would be interesting to assess the efficacy and feasibility of this treatment in primary care. The objectives of this study are to assess the potential efficacy and safety of autologous platelet rich plasma for the treatment of venous ulcers compared to the conventional treatment (moist wound care) in primary care patients with chronic venous insufficiency (C, clinical class, E, aetiology, A, anatomy and P, pathophysiology classification C6).

DESIGN

We will conduct a phase III, open-label, parallel-group, multicentre, randomized study. The subjects will be 150 patients aged between 40 and 100 years of age with an at least 2-month history of a vascular venous ulcer assigned to ten primary care centres. For the treatment with autologous platelet rich plasma, all the following tasks will be performed in the primary care setting: blood collection, centrifugation, separation of platelet rich plasma, activation of coagulation adding calcium chloride and application of the PRP topically after gelification. The control group will receive standard moist wound care. The outcome variables to be measured at baseline, and at weeks 5 and 9 later include: reduction in the ulcer area, Chronic Venous Insufficiency Quality of Life Questionnaire score, and percentage of patients who require wound care only once a week.

DISCUSSION

The results of this study will be useful to improve the protocol for using platelet rich plasma in chronic vascular ulcers and to favour wider use of this treatment in primary care.

TRIAL REGISTRATION

Current Controlled Trials NCT02213952.

摘要

背景

血管溃疡在各级医疗实践中都很常见,在个人、职业和社会层面都有很大影响,在人力和物力资源方面成本高昂。鉴于在医院环境中的各种不同研究表明,应用自体富血小板血浆可缩短愈合时间,我们认为评估这种治疗在初级保健中的疗效和可行性会很有意思。本研究的目的是评估在患有慢性静脉功能不全(C,临床分级;E,病因;A,解剖结构;P,病理生理分类C6)的初级保健患者中,与传统治疗(湿性伤口护理)相比,自体富血小板血浆治疗静脉溃疡的潜在疗效和安全性。

设计

我们将进行一项III期、开放标签、平行组、多中心随机研究。研究对象为150名年龄在40至100岁之间、患有血管性静脉溃疡且病程至少2个月的患者,这些患者被分配到10个初级保健中心。对于自体富血小板血浆治疗,所有以下操作都将在初级保健环境中进行:采血、离心、分离富血小板血浆、添加氯化钙激活凝血以及在凝胶化后局部应用富血小板血浆。对照组将接受标准的湿性伤口护理。在基线、第5周和第9周后要测量的结果变量包括:溃疡面积的减小、慢性静脉功能不全生活质量问卷评分以及每周仅需进行一次伤口护理的患者百分比。

讨论

本研究结果将有助于改进在慢性血管溃疡中使用富血小板血浆的方案,并促进这种治疗在初级保健中的更广泛应用。

试验注册

当前受控试验NCT02213952。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b243/4311495/6015ea1ac7dc/12875_2014_211_Fig1_HTML.jpg

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