前列地尔联合硫辛酸对2型糖尿病足患者的临床疗效及对血清VEGF、bFGF、IGF-1、MMP-2和足背动脉血流动力学指标的影响

Effects of alprostadil combined with lipoic acid on clinical efficacy,serum levels of vascular endothelial growth factor,bFGF,IGF-1 and MMP-2 and hemodynamic parameters of dorsal pedal artery in type 2 diabetic foot patients

目的探讨前列地尔联合硫辛酸对2型糖尿病足患者的临床疗效及对血清血管内皮生长因子(VEGF)、碱性成纤维细胞生长因子(bFGF)和胰岛素样生长因子(IGF)-1、基质金属蛋白酶(MMP)-2和足背动脉血流动力学指标的影响。方法选取2型糖尿病足患者128例作为研究对象,采用随机数字表法分为对照组64例和病例组64例。对照组给予硫辛酸治疗,病例组在对照组基础上给予注射用前列地尔。观察两组临床疗效、血清VEGF、bFGF、IGF-1和MMP-2及足背动脉血流动力学指标的变化。结果病例组总有效率显著高于对照组(P<0.05)。治疗后两组临床症状评分、MMP-2水平显著低于治疗前;血清VEGF、bFGF、IGF-1、血流流速、血管内径、阻力指数(RI)、搏动指数(PI)水平显著高于治疗前;且病例组临床症状评分、血清VEGF、bFGF、IGF-1和MMP-2、血流动力学指标改善情况显著优于对照组(P<0.05)。两组不良反应发生率比较差异无统计学意义(P>0.05)。结论前列地尔联合硫辛酸对2型糖尿病足患者的临床疗效显著,可以明显改善患者的临床症状评分、提高糖尿病足患者血清VEGF、bFGF、IGF-1水平,降低MMP-2水平,改善足背动脉血流动力学异常,具有较高的有效率和安全性。

Objective To investigate the clinical effect of alprostadil combined with lipoic acid on clinical efficacy,serum vascular endothelial growth factor(VEGF),basic fibroblast growth factor(bFGF),insulin-like growth factor(IGF)-1,matrix metalloproteinase(MMP)-2 and hemodynamic parameters of dorsal pedal artery in patients with type 2 diabetic foot.Methods 128 patients with type 2 diabetic foot hospitalized in the Deyang Second People′s Hospital from January 2014 to January 2019 were selected as the study subjects.64 cases in the control group and 64 cases in the case group were divided by random number table method.The control group was treated with lipoic acid,and the case group was treated with Alprostadil for injection on the basis of the control group.The clinical efficacy,serum levels of VEGF,bFGF,IGF-1,MMP-2 and hemodynamic parameters of dorsal pedal artery were observed.Results The total effective rate of the case group(95.31%)was significantly higher than that of the control group(81.25%,P<0.05).After treatment,the clinical symptom score and MMP-2 level of the two groups were lower than those before treatment,and the serum levels of VEGF,bFGF,IGF-1,blood flow velocity,vascular diameter,RI and PI were higher than those before treatment.The improvement of clinical symptom score,serum VEGF,bFGF,IGF-1,MMP-2 and hemodynamic indexes in the case group were significantly better than those in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions Alprostadil combined with lipoic acid has a significant clinical effect on type 2 diabetic foot.It can significantly improve the clinical symptom score,increase the serum levels of VEGF,bFGF,IGF-1,decrease the level of MMP-2,and improve the abnormal hemodynamics of dorsal pedal artery.It has a high efficiency and safety.It is worthy of further clinical promotion.