自体浓缩生长因子对老年糖尿病患者褥疮伤口的影响:一项病例对照研究。

Effect of autologous concentrated growth factor on bedsore wounds in elderly patients with diabetes: a case-control study.

作者信息

Bao Qin-Wen, Xu Jing, Wang Zhi, Hu Guangyun, Zhong Wen, Li Yunfeng, Dong Xiao-Lei, Xu Tong-Dao, Gao Chong

机构信息

Department of Geriatrics, Lianyungang Second People's Hospital Affiliated to Kangda College, Nanjing Medical University, Lianyungang, Jiangsu, China.

Department of Oncology, Lianyungang Second People's Hospital Affiliated to Kangda College, Nanjing Medical University, Lianyungang, Jiangsu, China.

出版信息

Front Endocrinol (Lausanne). 2025 Jul 18;16:1620730. doi: 10.3389/fendo.2025.1620730. eCollection 2025.

Abstract

BACKGROUND

Pressure ulcers, also known as bedsores, are common injuries to the skin and subcutaneous tissues in patients who are bedridden or wheelchair-bound, with a particularly high incidence among elderly patients with diabetes. These chronic wounds often lead to increased morbidity, prolonged hospitalization, and reduced quality of life. Traditional treatments for pressure ulcers have limited efficacy. In recent years, autologous concentrated growth factor (ACGF) has emerged as a promising regenerative medicine approach, showing potential in promoting wound healing through enhanced cell proliferation, accelerated angiogenesis, and improved tissue regeneration.

OBJECTIVE

This study aims to evaluate the effectiveness of ACGF in treating pressure ulcers in elderly diabetic patients by comparing wound healing, symptom relief, and inflammatory markers with those receiving conventional therapy.

METHODS

This analysis included 51 elderly patients aged 60 years or older with diabetes and pressure ulcers. Patients were divided into two groups: 26 received standard wound care (Control Group, CG), and 25 received ACGF treatment in addition to standard care (Treatment Group, TG). ACGF was prepared using a standardized protocol and applied directly to the wound site. Pain levels (VAS scores), wound healing (PUSH scores), and inflammatory markers (WBC, CRP, PCT, and IL-6) were compared between the two groups before treatment, 14 days, and 28 days after treatment.

RESULTS

VAS Scores: Before treatment, there was no significant difference between the two groups (TG: 6.92 ± 0.86, CG: 6.69 ± 1.01, P=0.392). At 14 days post-treatment, the VAS scores in the TG were significantly lower than those in the CG (TG: 3.52 ± 0.51, CG: 4.46 ± 0.58, P<0.001). By 28 days, the VAS scores in the TG further decreased (TG: 1.24 ± 0.44, CG: 1.58 ± 0.70, P=0.046). PUSH Scores: Before treatment, there was no significant difference between the two groups (TG: 14.84 ± 1.72, CG: 14.19 ± 1.92, P=0.211). At 14 days, the TG showed a significantly lower PUSH score than the CG (TG: 6.52 ± 0.71, CG: 8.23 ± 0.77, P<0.001). By 28 days, the PUSH scores in the TG continued to decrease (TG: 2.52 ± 0.59, CG: 3.39 ± 0.50, P=0.001). Inflammatory Markers: Before treatment, there were no significant differences in WBC, CRP, PCT, and IL-6 levels between the two groups (P>0.05). At 14 days post-treatment, the TG exhibited significantly lower levels of WBC (TG: 7.44 ± 1.56, CG: 8.60 ± 1.98, P=0.024) and PCT (TG: 0.63 ± 0.45, CG: 1.29 ± 0.48, P<0.01). By 28 days, the TG also showed significant reductions in CRP (TG: 5.93 ± 9.74, CG: 18.63 ± 6.62, P<0.01) and IL-6 (TG: 3.35 ± 1.89, CG: 5.56 ± 2.22, P<0.01).

CONCLUSION

This study suggests that ACGF is an effective adjunctive treatment for pressure ulcers in elderly diabetic patients. By significantly enhancing wound healing and reducing inflammatory responses, ACGF could serve as a valuable addition to standard care protocols for this vulnerable population. Further prospective studies are warranted to confirm these findings and explore the underlying mechanisms of ACGF in wound healing.

CLINICAL TRIAL REGISTRATION

https://www.medicalresearch.org.cn, identifier MR-32-24-019758.

摘要

背景

压疮,又称褥疮,是卧床或坐轮椅患者皮肤和皮下组织的常见损伤,在老年糖尿病患者中发病率尤其高。这些慢性伤口常导致发病率增加、住院时间延长和生活质量下降。传统的压疮治疗方法疗效有限。近年来,自体浓缩生长因子(ACGF)已成为一种有前景的再生医学方法,在通过增强细胞增殖、加速血管生成和改善组织再生来促进伤口愈合方面显示出潜力。

目的

本研究旨在通过比较伤口愈合、症状缓解及炎症标志物与接受传统治疗的患者,评估ACGF治疗老年糖尿病患者压疮的有效性。

方法

本分析纳入了51名60岁及以上患有糖尿病和压疮的老年患者。患者分为两组:26名接受标准伤口护理(对照组,CG),25名除标准护理外还接受ACGF治疗(治疗组,TG)。ACGF采用标准化方案制备并直接应用于伤口部位。比较两组治疗前、治疗后14天和28天的疼痛水平(视觉模拟评分法[VAS]评分)、伤口愈合情况(压疮愈合评分[PUSH]评分)及炎症标志物(白细胞、C反应蛋白、降钙素原和白细胞介素-6)。

结果

VAS评分:治疗前,两组之间无显著差异(TG:6.92±0.86,CG:6.69±1.01,P=0.392)。治疗后14天,TG的VAS评分显著低于CG(TG:3.52±0.51,CG:4.46±0.58,P<0.001)。到28天时,TG的VAS评分进一步降低(TG:1.24±0.44,CG:1.58±0.70,P=0.046)。PUSH评分:治疗前,两组之间无显著差异(TG:14.84±1.72,CG:14.19±1.92,P=0.211)。14天时,TG的PUSH评分显著低于CG(TG:6.52±0.71,CG:8.23±0.77,P<0.001)。到28天时,TG的PUSH评分继续降低(TG:2.52±0.59,CG:3.39±0.50,P=0.001)。炎症标志物:治疗前,两组白细胞、C反应蛋白、降钙素原和白细胞介素-6水平无显著差异(P>0.05)。治疗后14天,TG的白细胞水平(TG:7.44±1.56,CG:8.60±1.98,P=0.024)和降钙素原水平(TG:0.63±0.45,CG:1.29±0.48,P<0.01)显著更低。到28天时,TG的C反应蛋白(TG:5.93±9.74,CG:18.63±6.62,P<0.01)和白细胞介素-6(TG:3.35±1.89,CG:5.56±2.22,P<0.01)也显著降低。

结论

本研究表明,ACGF是老年糖尿病患者压疮的一种有效辅助治疗方法。通过显著促进伤口愈合和减轻炎症反应,ACGF可成为这一脆弱人群标准护理方案中有价值的补充。有必要进行进一步的前瞻性研究以证实这些发现,并探索ACGF在伤口愈合中的潜在机制。

临床试验注册

https://www.medicalresearch.org.cn,标识符MR-32-24-019758。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/41e6/12313496/49ce98986fd7/fendo-16-1620730-g001.jpg

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