Alprostadil combined recombinant bovine basic fibroblast growth factor in the treatment of diabetic foot view of efficacy
[Abstract] Objective To investigate the
clinical efficacy of alprostadil combined recombinant bovine basic fibroblast
growth factor in the treatment of diabetic foot. Methods January 2010 to
November 2012 were treated 70 cases of patients with diabetic foot patients
were randomly divided into treatment group and the control group, 35 cases in
each control group received intensive insulin therapy and glycemic control in
the ideal range (fasting plasma glucose of 4.4 to 6.1mmol / L, non-fasting
plasma glucose 4.4 to 8.0mmol / L, given antibiotics, nutrition nerve, wound
conventional debridement and dressing, basic treatment, the treatment group on
the basis of the treatment in the control group, plus alprostadil 10ug 30ml
micro pump 0.9% sodium chloride solution for 1 hour intravenous injection once
a day, wound debridement spraying recombinant bovine basic fibroblast growth
factor. 4 weeks continuous treatment, the efficacy of two groups were compared.
treatment group total effective rate of 94.3%, the control group, the total
effective rate was 57.1% .2 group difference was statistically significant
efficiency (χ 2 = 17.52, P <0.01. the conclusion of alprostadil joint
recombinant bovine basic fibroblast growth factor in the treatment of diabetic
foot better effect.
[Keywords] alprostadil recombinant bovine
basic fibroblast growth factor Diabetic Foot titles of papers
Diabetic foot diabetic patients is a result
of the merger of neuropathy and varying degrees of vascular lesions lower
extremity infections, ulcers, and (or deep tissue damage [1], the main clinical
manifestations of foot ulcers and gangrene, severe cases require amputation
paper make a summary of the 70 cases the efficacy of the treatment of diabetic
foot alprostadil combined recombinant bovine basic fibroblast growth factor.
1 Materials and Methods
1.1 General information from January 2010 to
November 2012 in our hospital 70 patients with diabetic foot were diabetes,
according to the 1999 WHO diagnostic criteria [2] confirm the diagnosis of type
2 diabetes. Randomly divided into a treatment group (35 cases and the control
group (35 patients in the treatment group, 20 males, 15 females, mean age (50 +
-3.5 years, mean disease duration (8.5 + -2.6 years, fasting plasma glucose
(9.1 +-2.6mmol / L in the control group, 20 males and 15 females, mean age (54
+ -5.5 years, mean disease duration (10.2 + -3.7 years, fasting blood glucose
(10.6 +-3.4mmol / L. baseline data comparing the two groups showed no
statistical significance (P> 0.05.
1.2 Methods Patients in both groups to
strengthen publicity and education of diabetes, strictly given to diabetic diet
should insulin pump to control blood sugar control fasting plasma glucose of
4.4 to 6.1mmol / L, and control non-fasting plasma glucose of 4.4 to 8.0mmol /
L in wound management before extraction secretions for bacterial culture, use
of effective antibiotics based on susceptibility testing results, and actively
to correct a variety of adverse affect wound healing diet control group:
aseptic ulcer wound debridement to use 1:200 polyamine ketone Vaseline gauze
covering the wound after iodine conventional disinfection, sterile gauze
bandage, dressing 1-3 times a day. treatment group: alprostadil 10ug added to
0.9% sodium chloride solution 30ml micro pump to maintain a 1 hour intravenous
injection once a day , at the same time, under aseptic the ulcer wound
debridement with 0.9% sodium chloride solution thoroughly wash the wound
sterile dry gauze exhaustion residue with recombinant bovine basic fibroblast
growth factor spray wound, dose 150AU / cm2, the wounds were given 1 to 3 days
the dressing 1 .2 were to assess the efficacy of continuous observation after 4
weeks.
1.3 determine the efficacy of the standard
based on Wagner grading down markedly: 2 lesions decreased wound healing>
80%, effective: a lesions decreased wound healing in 50% to 80%, invalid:
wounds do not improve or worsen the total efficiency = (number of cases
markedly + effective number of cases / total number of cases were observed
after 4 weeks of treatment efficacy.
1.4 Statistical Methods SPSS14.0 software
for statistical analysis, count data using χ2 test, P <0.05 for the
difference was statistically significant.
2 Results
2.1 treatment group (94.3% was significantly
higher (57.1% efficiency. Difference was statistically significant (χ2 = 17.52,
P <0.01, see Table 1.
2.2 adverse reaction control group and
treatment group had no adverse reaction.
3 Discussion
The occurrence of diabetic foot, mostly due
to poor blood glucose control, the state of the body a long period of high
sugar, resulting in the body's metabolic disorders, glucose can not get full
conversion and utilization of pathological changes in the vascular basement
membrane, resulting in vascular stenosis,
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Table 1 two groups compare 
Local microcirculation disorder occurs, nerve cells due to ischemia and hypoxia
cause swelling degeneration, axons, of hydrocele metabolic disorders and
changes in the microenvironment, neuropathy lack of protective response,
causing body the partial damage [3] Thus, diabetic foot treatment response to
vascular neuroprotective measures. Alprostadil is highly physiologically active
substances secreted by the body's own can improve hemodynamics and rheology
CAMP content in vascular smooth muscle cells by increasing its vasodilator role
lower peripheral resistance, inhibit platelet aggregation and reduce platelet
hyperreactivity and thromboxane A2 levels, inhibit platelet activation,
promoting platelet thrombus around the activated platelets reversal, to improve
the deformation capacity of red blood cells, and colleagues stimulate
endothelial cells to produce tissue type fibrinolytic substances (t-PA, has
direct thrombolytic effect, also free calcium by inhibiting vascular smooth
muscle cells, inhibition of vascular sympathetic nerve endings release
norepinephrine, the vascular smooth muscle relaxation, improve microcirculation
[4 - 5]. recombinant bovine basic fibroblast growth factor and as exogenous
multifunctional cell growth factors, on the one hand, you can promote diabetic
foot wounds capillary regeneration, improve local blood circulation, accelerate
healing, to change from passive to repair the initiative to promote wound
repair, and comprehensively improve the quality of wound healing, shorten
healing time, on the other hand can form a protective film on the wound after
disinfection, prevention of wound infection, accelerate healing [6-7] through
this set of experiments showed that the diabetic foot in the regular treatment
based on the joint application of alprostadil and recombinant bovine basic
fibroblast growth factor, can effectively promote the affected area tissue
recovery, is one of the effective treatment of diabetic foot.
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