前列地尔联合依帕司他治疗糖尿病足感染的疗效及对血清炎症因子水平的影响

Therapeutic effects of alprostadil combined with epalrestat in the treatment of diabetic foot infection and its influence on serum inflammatory factors

目的:探讨前列地尔联合依帕司他治疗糖尿病足感染(DFI)的疗效及对血清炎症因子水平的影响。方法:选取90例DFI患者为研究对象,按照治疗方式不同分为研究组和对照组,每组各45例。对照组患者在常规治疗基础上给予前列地尔注射液静脉滴注治疗;研究组患者在对照组疗法基础上联合口服依帕司他治疗,疗程均为21 d。比较两组患者治疗7 d时创面的肉芽组织覆盖率、肉芽组织生长厚度、细菌清除率及创面愈合时间,治疗前和治疗21 d时踝肱指数(ABI)及血清肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、超敏C反应蛋白(hs-CRP)水平及治疗7 d、21 d时的血糖、血脂指标;治疗期间不良反应发生情况。结果:治疗7 d时,研究组患者创面的肉芽组织覆盖率、肉芽组织生长厚度及细菌清除率高于对照组(P<0.05);创面愈合时间短于对照组(P<0.05)。治疗21 d时,两组患者ABI水平较治疗前上升(P<0.05),血清炎症因子水平较治疗前下降(P<0.05),血脂血糖水平均较治疗7 d时改善(P<0.05),且研究组患者上述指标水平均优于对照组(P<0.05)。两组患者治疗期间不良反应发生率比较,差异无统计学意义(P>0.05)。结论:DFI患者采用前列地尔联合依帕司他的治疗方案具有更好的临床效果,且安全性较好,值得临床推广应用。

Objective:To analyze the therapeutic effects of alprostadil combined with epalrestat in the treatment of diabetic foot infection(DFI) and its influence on serum inflammatory factors.Methods:90 cases of DFI patients were selected as the research subjects,and they were divided into study group and control group according to different treatment methods,45 cases in each group.The patients in the control group were treated with alprostadil injection intravenous drip on the basis of the conventional treatments,while the patients in the study group were treated with combined oral epalrestat on the basis of the control group therapy.Both groups were treated for 21 days.The granulation tissue coverage rate,the granulation tissue growth thickness,the bacterial clearance rate at 7 th day of treatment and the wound healing time between the patients in the two groups were observed and compared.The ankle brachial index(ABI) and the serum tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),high sensitivity C-reactive protein(hs-CRP) levels before and at 21 st days after treatment were detected and compared.The blood glucose and blood lipid indexes on 7 th and 21 th day after treatment between the pattients in the two groups were measured and compared.Adverse reactions during the treatment of the patients in the two groups were observed and compared.Results:At 7 th day of treatment,the granulation tissue coverage rate,the granulation tissue growth thickness and the bacterial clearance rate of the patients in the study group were higher than those in the control group,and the wound healing time of the patients in the study group was shorter than that in the control group(P<0.05).At 21 st day of treatment,the level of ABI increased and the levels of serum inflammatory factors decreased in the two groups,the levels of blood lipid and blood glucose were significantly improved compared with theose on 7 th day of treatment(P<0.05),and the levels of the above indicators of the patients in the study group were 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).Conclusion:The application of alprostadil combined with epalrestat for patients with DFI has better clinical effect and good safety,which is worthy of clinical application.