将胰岛素滴注与负压伤口治疗相关联可降低糖尿病足部感染患者的胰岛素抵抗

IF 4.6 2区 教育学 Q1 EDUCATION & EDUCATIONAL RESEARCH
Xin-long Chen
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引用次数: 0

摘要

在这项工作中,我们研究了胰岛素滴注和负压伤口治疗(NPWT)的联合治疗是否会降低糖尿病足溃疡(DFU)感染患者的胰岛素抵抗(IR)并改善其愈合。我们还研究了胰岛素+NPWT治疗对炎症反应和伤口愈合的影响。招募75名感染DFU的糖尿病患者,并随机分为相等(n=25)组,分别用NPWT单独治疗、NPWT+胰岛素治疗和常规敷料治疗(对照)。之后,评估溃疡的愈合进展。使用特异性双抗体夹心酶联免疫吸附试验(ELISA)在每次治疗前1天和治疗后7、14和21天测量血清肿瘤坏死因子-α(TNF-α)、白细胞介素-2(IL-2)和白细胞介素-6(IL-6)的水平。通过葡萄糖氧化酶法测定血清葡萄糖,通过放射免疫法测定血清胰岛素。在每个患者中,通过稳态模型评估(HOMA-IR)和定量胰岛素敏感性检查指数(QUICKI)评估IR。我们的结果显示,在治疗后7、14和21天,与对照组相比,两个NPWT治疗组(i)血清TNF-α、IL-2和IL-6水平显著降低(p<0.05);(ii)IR显著(p<0.01)降低;和(iii)显著(p<0.05)较高的伤口愈合率。此外,在治疗后14天和21天,NPWT+胰岛素治疗组的伤口愈合率显著高于(p<0.05)NPWT单独治疗组。总之,在感染DFU的糖尿病患者中,NPWT+胰岛素滴注联合治疗通过改善伤口愈合、减少伤口表面炎症和减少IR而产生了优越的效果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Associating Insulin Instillation with Negative Pressure Wound Therapy Reduces Insulin Resistance in Diabetic Patients with Infected Foot Wounds
In this work we investigated whether a joint treatment with insulin instillation and negative pressure wound therapy (NPWT) would reduce insulin resistance (IR) in diabetic patients with infected diabetic foot ulcers (DFUs) and improve their healing. We also studied the effects of insulin+NPWT treatment on the inflammatory response coupled with wound healing. Seventy-five diabetic patients with infected DFUs were recruited and randomly divided into equal (n=25) groups treated respectively with NPWT alone, NPWT+insulin, and conventional dressings (controls). Thereafter, the ulcers’ healing progress was assessed. The serum levels of Tumor Necrosis Factor-α (TNF-α), Interleukin-2 (IL-2), and Interleukin-6 (IL-6) were measured at 1 day before and at 7, 14, and 21 days after each treatment using specific double-antibody sandwich enzyme-linked immunosorbent assays (ELISA). Serum glucose was measured via a glucose-oxidase method, and serum insulin via radioimmunoassay. In each patient, IR was appraised via the Homeostasis Model Assessment (HOMA-IR) and the quantitative insulin sensitivity check index (QUICKI). Our results showed that at 7, 14 and 21 days post-treatment, with respect to the control group the two NPWT-treated groups had (i) significantly (p < 0.05) lower serum levels of TNF-α, IL-2 and IL-6; (ii) a significantly (p < 0.01) greater reduction in IR; and (iii) significantly (p < 0.05) higher wound healing rates. Moreover, at 14- and 21-days post-treatment, the NPWT+insulin-treated group had a significantly (p < 0.05) higher wound healing rate than the NPWT alone-treated group. In conclusion, the combined NPWT+insulin instillation treatment gave superior results by improving wound healing, decreasing inflammation at the wounds surface, and reducing IR in diabetic patients with infected DFUs.
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来源期刊
Educational Technology & Society
Educational Technology & Society EDUCATION & EDUCATIONAL RESEARCH-
CiteScore
9.10
自引率
2.50%
发文量
1
审稿时长
20 weeks
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