富含血小板血浆（PRP）治疗糖尿病足溃疡（DFU）：最新随机对照试验的系统综述和荟萃分析

IF 1 Q4 ENDOCRINOLOGY & METABOLISM

Diabetes epidemiology and management Pub Date : 2023-08-23 DOI:10.1016/j.deman.2023.100178

Fara Syafira , Muhammad Baharul Iman , Pariyana , Rita Sriwulandari

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引用次数: 0

摘要

目的:糖尿病足溃疡(DFU)是糖尿病的一种常见且严重的并发症，具有较高的发病率和死亡率。富血小板血浆(PRP)是一种很有前景的加速DFU愈合的治疗方法，许多随机对照试验(rct)支持其有效性和安全性。因此，本系统综述旨在识别、批判性评估和综合最新可用的rct，与标准治疗或其他替代疗法相比，临床PRP治疗DFU的有效性。方法:本研究根据2020年PRISMA(系统评价和荟萃分析的首选报告项目)指南对现有研究进行了全面的回顾和综合。我们在过去五年中(2018-2023)从PubMed、ProQuest、ScienceDirect和谷歌Scholar中使用搜索词组合检索选定的数据库:“(PRP) OR(“富血小板血浆”))AND(“糖尿病足溃疡”)OR(“糖尿病下肢溃疡”))。根据系统评价方案，我们选择了9篇符合条件的文章进行最终分析。使用MedCalc 20.215版本检查相关数据，然后使用森林图可视化显示结果。结果荟萃分析结果显示，PRP组的治愈率是对照组的两倍(相对效应(REs) = 2.338;95%置信区间(CI) = 1.056 ~ 1.857, P = 0.019)。愈合时间缩短2 d (REs = -2.815;95% CI = -3.252 ~ -0.576, P = 0.005)，两组患者溃疡面积缩小差异0.482 cm2 (REs = 0.482;95% CI = -2.428 ~ 4.002, P = 0.630)。重要的是，没有一项随机对照试验(RCT)研究报告PRP组有任何不良事件。结论sprp是治疗DFU的一种可行、安全的辅助治疗方法。

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Platelet-rich plasma (PRP) as therapy for diabetic foot ulcer (DFU): A systematic review and meta-analysis of the latest randomized controlled trials

Objectives

Diabetic foot ulcer (DFU) is a prevalent and serious complication of diabetes, associated with significant morbidity and mortality rates. Platelet-rich plasma (PRP) is a promising therapy for accelerating DFU healing, with numerous randomized controlled trials (RCTs) supporting its efficacy and safety. Therefore, this systematic review aims to identify, critically assess, and synthesize the most recent available RCTs regarding the effectiveness of clinical PRP for treating DFU compared to standard treatment or other alternative therapies.

Methods

This study uses a comprehensive review and synthesis of existing research according to the 2020 PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. We searched selected databases using a combination of search terms: “((PRP) OR ("platelet-rich plasma")) AND ("diabetic foot ulcer")) OR ("diabetic lower-extremity ulcer"))” from PubMed, ProQuest, ScienceDirect, and Google Scholar in the last five years (2018–2023). Following a systematic review protocol, we selected 9 eligible articles for final analysis. Pertinent data was examined using MedCalc ver 20.215 then the results were displayed visually using forest plots.

Results

The findings from the meta-analysis revealed that PRP exhibited a healing rate that was twice as high as the control group (Relative Effects (REs) = 2.338; 95% Confidence Interval (CI) = 1.056 to 1.857, P = 0.019). Additionally, the healing time was shortened by 2 days (REs = -2.815; 95% CI = -3.252 to -0.576, P = 0.005), and there was a difference of 0.482 cm² in the reduction of ulcer area between the two groups (REs = 0.482; 95% CI = -2.428 to 4.002, P = 0.630). Importantly, none of the Randomized Controlled Trials (RCT) studies reported any adverse events in the PRP group.