Wang Yanling, Liu Bang, Pi Yinzhen, Hu Li, Yuan Yeling, Luo Jiao, Tao Yixiao, Li Ping, Lu Shan, Song Wei
Changsha Maternal and Child Health Hospital Affiliated to Hunan Normal University, Changsha, China.
The First Hospital of Changsha, Changsha, China.
Front Pharmacol. 2022 Dec 16;13:1051299. doi: 10.3389/fphar.2022.1051299. eCollection 2022.
The purpose of this study was to assess the risk factors for morbidity and mortality of diabetic foot ulcers (DFUs). For the treatment of diabetic foot ulcers, negative pressure wound therapy (NPWT) combined with platelet-rich plasma-fibrin glue (PRP) was also investigated. There were 653 patients in the diabetic foot ulcer group and 510 patients in the diabetic patients without foot ulceration (NFU) group, for a total of 1163 patients in the study samples after individuals without follow-up were excluded. The patients were randomized into two groups: the negative pressure wound therapy group and the negative pressure wound therapy combined with the PRP group. The findings of the univariate analysis revealed the blood indicators for predicting diabetic foot ulcer morbidity risk factors, such as C-reactive protein, albumin, creatinine, alkaline phosphatase, procalcitonin, platelets, 25-hydroxyvitamin D, β-2-microglobulin, monocyte ratio, low-density protein cholesterol (LDL), triglyceride, alanine aminotransferase (ALT), aminotransferase (AST), creatine kinase (CK) and total cholesterol. Using logistic regression analysis revealed only albumin and age to be independent predictors of diabetic foot ulcer mortality. Our study also revealed that, compared to negative pressure wound therapy alone, negative pressure wound therapy combined with PRP accelerated wound healing and reduced the mortality rate. According to the findings of this pilot study, new risk factors for diabetic foot ulcer morbidity and mortality have been found, and negative pressure wound therapy combined with PRP therapy may provide the first information that it is an effective adjunct treatment for diabetic foot ulcers.
本研究的目的是评估糖尿病足溃疡(DFU)发病和死亡的风险因素。对于糖尿病足溃疡的治疗,还研究了负压伤口治疗(NPWT)联合富血小板血浆 - 纤维蛋白胶(PRP)。糖尿病足溃疡组有653例患者,无足溃疡糖尿病患者(NFU)组有510例患者,排除无随访个体后,研究样本共有1163例患者。患者被随机分为两组:负压伤口治疗组和负压伤口治疗联合PRP组。单因素分析结果揭示了预测糖尿病足溃疡发病风险因素的血液指标,如C反应蛋白、白蛋白、肌酐、碱性磷酸酶、降钙素原、血小板、25 - 羟基维生素D、β - 2微球蛋白、单核细胞比例、低密度脂蛋白胆固醇(LDL)、甘油三酯、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、肌酸激酶(CK)和总胆固醇。使用逻辑回归分析显示只有白蛋白和年龄是糖尿病足溃疡死亡率的独立预测因素。我们的研究还表明,与单纯负压伤口治疗相比,负压伤口治疗联合PRP可加速伤口愈合并降低死亡率。根据这项初步研究的结果,已发现糖尿病足溃疡发病和死亡的新风险因素,并且负压伤口治疗联合PRP治疗可能首次提供了其是糖尿病足溃疡有效辅助治疗的信息。