Steed D L, Ricotta J J, Prendergast J J, Kaplan R J, Webster M W, McGill J B, Schwartz S L
Department of Surgery, University of Pittsburg, Pennsylvania 15213.
Diabetes Care. 1995 Jan;18(1):39-46. doi: 10.2337/diacare.18.1.39.
To determine the effectiveness and safety of arginine-glycine-aspartic acid (RGD) peptide matrix in the treatment of diabetic foot ulcers.
This randomized placebo-controlled investigator- and patient-blinded prospective multicenter investigation was conducted at three institutional and three private U.S. clinics providing ambulatory care. Sixty-five diabetic patients with chronic full-thickness neurotrophic foot ulcers were enrolled. Six discontinued the study because of adverse events. RGD peptide matrix (Argidene Gel; formerly Telio-Derm Gel) was applied topically twice weekly for up to 10 weeks in patients who otherwise received standard care. Control group patients received topical saline as a placebo plus standard care. The primary method of assessment was the incidence and rate of ulcer closure. All patients enrolled were included in the data analysis.
The percentage of patients whose ulcers healed completely in the RGD peptide matrix group (35%; 14 of 40 patients) was over fourfold greater (P = 0.02) than that in the placebo group (8%; 2 of 25 patients). By the study end point (either day of healing or week 10), 30 of 40 (75%) RGD peptide matrix patients had achieved > 50% ulcer closure compared with 12 of 25 (48%) placebo patients (P = 0.03). RGD peptide matrix also significantly (P = 0.03) increased the rate of ulcer closure over the 10 weeks of the study.
RGD peptide matrix treatment promoted and accelerated the healing of chronic diabetic foot ulcers to a significant degree.
确定精氨酸 - 甘氨酸 - 天冬氨酸(RGD)肽基质治疗糖尿病足溃疡的有效性和安全性。
这项随机、安慰剂对照、研究者和患者双盲的前瞻性多中心研究在美国的三家机构诊所和三家私人门诊诊所进行,这些诊所提供门诊护理。招募了65例患有慢性全层神经性足部溃疡的糖尿病患者。6例因不良事件退出研究。RGD肽基质(Argidene凝胶;原称Telio - Derm凝胶)每周两次局部应用,最长应用10周,患者同时接受标准护理。对照组患者接受局部生理盐水作为安慰剂加标准护理。主要评估方法是溃疡愈合的发生率和愈合速度。所有纳入的患者均纳入数据分析。
RGD肽基质组溃疡完全愈合的患者百分比(35%;40例患者中的14例)比安慰剂组(8%;25例患者中的2例)高出四倍多(P = 0.02)。到研究终点(愈合日或第10周)时,40例RGD肽基质组患者中有30例(75%)溃疡闭合超过50%,而25例安慰剂组患者中有12例(48%)(P = 0.03)。在研究的10周内,RGD肽基质也显著(P = 0.03)提高了溃疡闭合速度。
RGD肽基质治疗在很大程度上促进并加速了慢性糖尿病足溃疡的愈合。