利拉鲁肽治疗糖尿病足的临床疗效及对血管生成因子的影响

Effect of Liraglutide on Clinical Efficacy and Its influence on Angiogenic Factors in Diabetic Foot

目的探讨胰高血糖素样肽-1受体激动剂(利拉鲁肽)治疗糖尿病足的临床疗效及对血管生成因子的影响。方法研究纳入80例糖尿病足患者,随机分为对照组和观察组。对照组给予降血糖、局部创面处理、抗感染等常规治疗;观察组在常规治疗的基础上予以利拉鲁肽治疗。观察治疗后患者临床疗效及血管生成因子水平(血管内皮生长因子、碱性成纤维细胞生长因子、色素上皮衍生因子)、血液流变学的变化。结果与对照组相比,观察组治愈率和有效率(P=0.003)更高,血液流变学得到改善(P<0.01);利拉鲁肽治疗后患者血清血管内皮生长因子、碱性成纤维细胞生长因子水平均升高及色素上皮衍生因子水平降低(P<0.01),与对照组比较,观察组血清血管内皮生长因子、碱性成纤维细胞生长因子水平均升高更明显及色素上皮衍生因子水平降低更明显(P<0.01)。结论利拉鲁肽可能通过调节血管生成因子表达、改善血液流变学,进而有利于糖尿病足患者创面愈合。

Objective To analyze the clinical efficacy of glucagon-like peptide-1 receptor agonist(liraglutide)in the treatment of diabetic foot and its influence on patientsˊserum of angiogenic factors.Methods Totally 80 patients with diabetic foot were randomly chosen and divided into control group and observation group.The control group was given conventional treatment such as hypoglycemic therapy,local wound treatment and anti-infection,while the observation group received additional treatment with liraglutide on the basis of conventional treatment.The changes of clinical efficacy and blood rheology were observed,and the changes of serum levels of angiogenic factor levels(VEGF,bFGF,PEDF)were detected before and after treatment.Results After treatment,compared with the control group(P=0.003),the cure rate and effective rate of the observation group were higher,and the blood rheology was improved(P<0.01).After treatment with liraglutide,serum VEGF and bFGF levels were increased and PEDF levels were decreased,the differences were statistically significant(P<0.01).Compared with the control group,serum VEGF and bFGF levels were increased more obviously and PEDF levels were decreased more obviously in the observation group.Conclusion Liraglutide may regulate the expression of angiogenic factors and improve blood rheology in addition to lowering blood glucose,thus contributing to wound healing in patients with diabetic foot.