Xu Yan, Fu Xiaohu, Chen Fuying
Department of Internal Medicine, Jiangxi Medical College Shangrao, Jiangxi, China.
Department of General Internal Medicine, The First Affiliated Hospital of Jiangxi Medical College Shangrao, Jiangxi, China.
Am J Transl Res. 2023 Oct 15;15(10):6208-6216. eCollection 2023.
This study was designed to determine the efficacy of epalrestat on patients with diabetic foot infection (DFI) and its effects on serum inflammatory factors in the patients.
The data of 80 patients with DFI treated in the First Affiliated Hospital of Jiangxi Medical College from May 2020 to May 2022 were analyzed retrospectively. Among them, patients who received routine comprehensive treatment were enrolled into the control group (n=37), and those who received epalrestat on the basis of routine comprehensive treatment were enrolled into the study group (n=43). The changes of serum inflammatory factors before and after treatment, granulation tissue grading and efficacy in the two groups were analyzed and compared, and the wound healing time, hospitalization time and adverse reactions (including nausea and vomiting, dizziness, headache, pruritus, etc.) of the two groups were statistically analyzed. The prognosis of the patients within 1 year after treatment was analyzed, and the independent risk factors of poor prognosis were analyzed through logistic regression.
Before treatment, the two groups were not significantly different in the levels of tumor necrosis factor-α (TNF-α), high sensitivity C-reactive protein (hs-CRP), and interleukin-6 (IL-6), while after treatment, the levels decreased significantly in both groups, with significantly lower levels in the study group than those in the control group. The study group had a significant lower proportion of patients with grade 0/grade 1 granulation tissue than the control group, and had a significantly higher proportion of patients with grade 2/grade 4 granulation tissue than the control group, but the proportion of patients with grade 3 granulation tissue in the two groups was not greatly different. The study group experienced notably shorter wound healing time and hospitalization time than the control group. A notably higher overall response rate was found in the study group than that in the control group. In addition, the total incidence of adverse reactions was not greatly different between the two groups. BMI, diabetes mellitus type, Wagner grading and classification of diabetic foot infection were found to be the risk factors affecting the prognosis of patients, and Wagner grading was an independent risk factor affecting the prognosis of patients.
Epalrestat is effective in treating DFI, because it can lower the levels of serum inflammatory factors, shorten the time of wound healing and hospitalization, and promote the growth and recovery of granulation, without increasing adverse reactions. Therefore, it is worthy of clinical promotion.
本研究旨在确定依帕司他对糖尿病足感染（DFI）患者的疗效及其对患者血清炎症因子的影响。
回顾性分析2020年5月至2022年5月在江西医学院第一附属医院接受治疗的80例DFI患者的数据。其中，接受常规综合治疗的患者纳入对照组（n = 37），在常规综合治疗基础上接受依帕司他治疗的患者纳入研究组（n = 43）。分析比较两组治疗前后血清炎症因子的变化、肉芽组织分级及疗效，并对两组的伤口愈合时间、住院时间及不良反应（包括恶心、呕吐、头晕、头痛、瘙痒等）进行统计学分析。分析患者治疗后1年内的预后情况，并通过逻辑回归分析预后不良的独立危险因素。
治疗前，两组患者的肿瘤坏死因子-α（TNF-α）、高敏C反应蛋白（hs-CRP）和白细胞介素-6（IL-6）水平无显著差异，而治疗后，两组水平均显著下降，研究组水平显著低于对照组。研究组0/1级肉芽组织患者比例显著低于对照组，2/4级肉芽组织患者比例显著高于对照组，但两组3级肉芽组织患者比例差异不大。研究组的伤口愈合时间和住院时间明显短于对照组。研究组的总有效率明显高于对照组。此外，两组不良反应总发生率差异不大。发现体重指数、糖尿病类型、瓦格纳分级和糖尿病足感染分类是影响患者预后的危险因素，瓦格纳分级是影响患者预后的独立危险因素。
依帕司他治疗DFI有效，因为它可以降低血清炎症因子水平，缩短伤口愈合时间和住院时间，促进肉芽生长和恢复，且不增加不良反应。因此，值得临床推广。
