重组人粒细胞集落刺激因子联合抗菌药物对糖尿病足感染患者VEGF及Flt-1的影响

Effect of rhG-CSF injection combined with systemic antibacterials on VEGF and Flt-1 in patients with diabetic foot infection

目的探讨重组人粒细胞集落刺激因子(rhG-CSF)注射液联合全身抗菌药物治疗对糖尿病足感染(DFI)患者血管内皮生长因子(VEGF)及其受体Flt-1的影响。方法选取2015年7月至2016年7月在该院接受治疗的DFI患者78例,随机分为两组,每组各39例,对照组给予常规治疗和左氧氟沙星静脉滴注,观察组在对照组治疗的基础上给予rhG-CSF注射液皮下注射。治疗30d,观察两组患者治疗效果及血清中VEGF、Flt-1水平变化。结果治疗后,观察组总有效率明显高于对照组,差异有统计学意义(P<0.05),创面面积明显小于对照组,差异有统计学意义(P<0.05);两组肉芽生长时间和上皮形成时间比较,差异有统计学意义(P<0.05)。对照组治疗前、后血清VEGF、Flt-1水平比较,差异无统计学意义(P>0.05);观察组治疗后血清VEGF、Flt-1水平高于治疗前,差异有统计学意义(P<0.05);观察组治疗后VEGF、Flt-1水平高于对照组,差异有统计学意义(P<0.05)。结论 rhG-CSF与全身抗菌药物联合应用可促进VEGF、Flt-1的表达,缩短上皮细胞形成时间,有效降低创面面积,提高DFI的治疗效果。

Objective To investigate the effects of recombinant human granulocyte colony stimulating factor（rhG-CSF）injection combined with systemic antibacterials on VEGF and its receptor Flt-1in patients with diabetic foot infection（DFI）.Methods A total of 78 cases of patients with DFI in our hospital were selected from July 2015 to July 2016,and were randomly divided into two groups,39 cases in each group.The control group received routine treatment and intravenous drip of levofloxacin,and the observation group was given subcutaneous injection of rhG-CSF on the basis of the control group.After 30 days of treatment,the therapeutic effect and serum levels of VEGF and Flt-1in two groups were observed.Results After treatment,the total effective rate of observation group was significantly higher than that of the control group（P〈0.05）;the wound area was significantly lower than the control group（P〈0.05）;and the difference of granulation growth days and epithelium formation days between the two groups was statistically significant（P〈0.05）.The levels of VEGF and Flt-1in the control group after the treatment showed no significant difference when compared with that before the treatment（P〉0.05）,but the difference in the observation grop was statistically significant（P〈0.05）.The levels of VEGF and Flt-1in the observation group were significantly higher than those in the control group（P〈0.05）.Conclusion The combination of rhG-CSF and systemic antibacterials can promote the expression of Flt-1and VEGF,shorten the days of epithelial cell formation and reduce the wound area,which is effective in the treatment of DFI.