【摘要】 目的 观察自体富血小板凝胶治疗糖尿病足溃疡(DFU)的疗效。方法 72例DFU患者按照数字随机法分为两组。治疗组采用自体富血小板凝胶外敷;对照组采用常规疗法。比较两组DFU治愈率、好转率及愈合时间。 结果 两组间年龄、糖尿病病程、FPG、FIns、HbA1c 、稳态模型评估胰岛素抵抗指数(HOMA-IR)、BMI、TG、TC、LDL-C、HDL-C、溃疡面积及溃疡体积比较差异均无统计学意义(P>0.05)。两组WagnerⅠ级足溃疡的疗效比较差异均无统计学意义(P>0.05)。在WagnerⅡ、Ⅲ级DFU病例中，治疗组在治愈率(66.7%、70.0%)、总有效率(94.4%、90.0%)均明显高于对照(26.3%、57.9%;10.0%、30.0%)组(P<0.05);治疗组WagnerⅠ~Ⅲ级溃疡愈合时间均短于对照组[Ⅰ级：(14.75±1.82)vs (22.00±1.63)d;Ⅱ级：(27.12±2.15)vs (34.93±1.44)d; Ⅲ级：(41.89±3.22)vs (53.83±1.17)d] (P<0.05)。 结论 自体富血小板凝胶具有促进DFU愈合的作用。

　　【关键词】血小板凝胶;糖尿病足;溃疡;治疗

　　【Abstract】Objective To evaluate the efficacy of autologous platelet-rich gel (APG) in the treatment of diabetic foot ulcers.Methods 72 patients with diabetic foot ulcers patients accepted observation ,physical examination and blood sample detection. All the 72 patients were random classified into two groups, autologous platelet-rich gel treatment group and control group,to compare the recovery rate, effective rate and recovery time of DFU between the two groups. Results The factors, age, diabetes duration, FPG, FIns, HbA1c,the steady-state model assessment of insulin resistance index (HOMA-IR), BMI, TG, TC, LDL- C, HDL-C, area and volume of ulcer,shows no significant differences betweent the two groups(P > 0.05). All the WagnerⅠpatients were cured in APG treatment group,while 6 patients were cured in control group. The numbers of Wagner Ⅱpatients cured in APG treatment group and control group were 12 and 5 respectively. Five WagnerⅡpatients were found to get better in APG treatment group, and 10 patients in control group improved.For WagnerⅢpatients, 7 were cured in APG treatment group,and 1 in control group. Both APG treatment group and control group have two improved Wagner Ⅲ patients. The analysis of chi-square showed that for WagnerⅡ-Ⅲpatients, the recovery rate and effective rate of diabetic foot ulcers in APG treatment group(recovery rate were 66.7% and 70.0%;Effective rate were 94.4% and 90.0%) are significantly greater than control group(26.3%、57.9%;10.0%、30.0%)(P<0.05).There is no significant difference in WagnerⅠpatients(P>0.05). The analysis of chi-square showed that recovery time and effective time of WagnerⅠ-Ⅲ DFU patients in APG treatment group are significantly shorter than control group(Ⅰ: (14.75±1.82)vs (22.00±1.63)d;Ⅱ:(27.12±2.15)vs (34.93±1.44)d; Ⅲ:(41.89±3.22)vs (53.83±1.17)d, P<0.05). Conclusion Autologous platelet-rich gel plays an important role in the treatment of diabetic foot ulcers.

　　【Key words】platelet-rich gel; diabetic foots;ulcer; therapy