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非愈合性糖尿病溃疡中自体非培养角质形成细胞悬液:一项初步研究。

Autologous non-cultured keratinocyte cell suspension in non-healing diabetic ulcers: A preliminary study.

作者信息

Barnwal Shruti, Kant Ravi, Yadav Poonam

机构信息

Department of Dermatology, Govt. Doon Medical College, Dehradun, Uttarakhand, India.

Department of Medicine, Division of Diabetes and Metabolism, AIIMS, Rishikesh, Uttarakhand, India.

出版信息

J Family Med Prim Care. 2020 Sep 30;9(9):4686-4691. doi: 10.4103/jfmpc.jfmpc_627_20. eCollection 2020 Sep.

Abstract

BACKGROUND

Diabetic ulcers are a common morbidity associated with poorly controlled glycemic status. Most patients often have neuropathy and vasculopathy as the etiology behind such ulcers. These factors not only lead to poor wound healing but also nonhealing ulcers. Nonhealing ulcers pose therapeutic challenges as they are usually not amenable to be treated with simple wound care and hence require newer modalities to effectively cure this condition that leads to a plethora of poor health outcomes. This study was conducted to see the effect of autologous noncultured keratinocyte cell suspension in chronic nonhealing diabetic ulcers that failed to normal wound care.

MATERIAL AND METHODS

It was an observational pilot study. A total of 05 patients with nonhealing ulcers, attending the tertiary care teaching hospital in North India, were included in the study. Inclusion criteria was type 2 DM with more than 5 years duration of diabetes mellitus and glycated hemoglobin (HbA1c) <9 g%. History was taken in detail; name, age, sex, address, duration of disease and various other treatments taken from outside were noted; and size of ulcer was recorded as per Proforma.

RESULTS

A total of 5 patients were enrolled in the study, three (60%) and two (40%) patients were male and female, respectively. Three (60%) patients were habitual for tobacco use. Mean age of patients was 45 ± 6.51 years. Mean duration of ulcers was 4.8 ± 1.48 months. Area of ulcers ranged from 31.2 to 122.2 cm. Majority of cases, three (60%) of diabetic foot ulcers, were improved at 9-12 weeks and remaining two cases with large size of ulcer were healed at 13-16 weeks and 17-20 weeks, respectively. Majority (80%) of patients revealed >50% reduction in the size of ulcer within 2 weeks.

CONCLUSION

Noncultured keratinocytes are useful in healing of nonhealing diabetic ulcer.

摘要

背景

糖尿病溃疡是血糖控制不佳时常见的一种病症。大多数患者常伴有神经病变和血管病变,这是此类溃疡的病因。这些因素不仅导致伤口愈合不良,还会造成溃疡不愈合。不愈合的溃疡带来了治疗挑战,因为它们通常无法通过简单的伤口护理得到治疗,因此需要更新的治疗方式来有效治愈这种会导致大量不良健康后果的病症。本研究旨在观察自体非培养角质形成细胞悬液对经常规伤口护理后仍不愈合的慢性糖尿病溃疡的疗效。

材料与方法

这是一项观察性试点研究。共有5例不愈合溃疡患者纳入研究,这些患者来自印度北部的一家三级护理教学医院。纳入标准为2型糖尿病,糖尿病病程超过5年且糖化血红蛋白(HbA1c)<9%。详细记录病史;记录姓名、年龄、性别、地址、病程以及之前接受的各种其他治疗;并按表格记录溃疡大小。

结果

共有5例患者纳入研究,男性3例(60%),女性2例(40%)。3例(60%)患者有吸烟习惯。患者的平均年龄为45±6.51岁。溃疡的平均病程为4.8±1.48个月。溃疡面积在31.2至122.2平方厘米之间。大多数病例,即3例(60%)糖尿病足溃疡,在9至12周时有所改善,其余2例溃疡面积较大的病例分别在13至16周和17至20周时愈合。大多数(80%)患者在2周内溃疡面积缩小>50%。

结论

非培养角质形成细胞对不愈合的糖尿病溃疡愈合有用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fbc5/7652156/8f2fd71a567d/JFMPC-9-4686-g001.jpg

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