高压氧联合硫辛酸治疗糖尿病足对血管生成因子水平、周围神经传导速度及血小板的影响

Clinical efficacy of hyperbaric oxygen combined with lipoic acid on diabetic foot and its effect on angiogenic factors,peripheral nerves,and platelets

目的探讨高压氧(HBO)联合硫辛酸治疗糖尿病足(DF)的临床疗效及对血管生成因子、周围神经传导速度及血小板参数的影响。方法选取临沂市中心医院内分泌科2017年6月至2020年6月收治的92例DF患者,按随机数字表法分为观察组(HBO联合硫辛酸治疗)和对照组(硫辛酸治疗),每组46例。比较2组患者的临床疗效及治疗前后血管生成因子水平、周围神经传导速度及血小板参数。结果观察组的治疗总有效率(91.30%)显著高于对照组(76.09%),差异有统计学意义(χ2=3.903,P<0.05)。治疗后2组患者的血管内皮生长因子(VEGF)、碱性成纤维细胞生长因子(bFGF)水平较治疗前均显著升高,且观察组显著高于对照组(P<0.05)。治疗后2组患者腓总神经、正中神经的运动、感觉神经传导速度较治疗前均显著升高,且观察组显著高于对照组(P<0.05)。治疗后2组患者的血小板计数较治疗前显著升高,且观察组显著高于对照组(P<0.05);血小板分布宽度、平均血小板体积较治疗前显著降低,观察组显著低于对照组(P<0.05)。结论HBO联合硫辛酸能显著改善DF患者血管生成及血小板功能,促进周围神经功能恢复,提高临床疗效。

Objective To investigate the curative effect of hyperbaric oxygen(HBO)combined with lipoic acid in the treatment of diabetic foot(DF)and its influence on angiogenic factors,peripheral nerve conduction velocity,and platelet parameters.Methods A total of 92 patients with DF who were admitted to Linyi Central Hospital from June 2017 to June 2020 were selected.They were randomly divided into observation group(HBO combined with lipoic acid treatment)and control group(lipoic acid treatment only)according to the random number table method,with 46 patients in each group.Before and after treatment,the clinical efficacy,vascular endothelial growth factor(VEGF),peripheral nerve conduction velocity,and platelet parameters between the two groups were compared.Results The total effective rate in the observation group(91.30%)was significantly higher than that in the control group(76.09%).After treatment,VEGF and basic fibroblast growth factor(bFGF)were significantly increased compared with those before treatment,and the two indicators in the observation group were significantly higher than those in the control group(P<0.05).After treatment,the motor and sensory nerve conduction velocities of the common peroneal nerve and median nerve were significantly increased compared with those before treatment,and the two velocities in the observation group were significantly higher than those in the control group(P<0.05).The platelet counts in both groups were significantly increased compared with those before treatment,and the count in the observation group was significantly higher than that in the control group(P<0.05);the platelet distribution widths and mean platelet volumes were significantly decreased compared with those before treatment,and the width and volume in the observation group were significantly lower than those in the control group(P<0.05).Conclusion HBO combined with lipoic acid can significantly improve angiogenesis and platelet function in DF patients,promote peripheral nerve recovery,thus improving clinical efficacy.