糖尿病足是糖尿病最严重的慢性并发症之一,具有较高的致残率和致死率,其发病机制十分复杂,与外周神经病变和下肢动脉缺血有关,也与外伤、感染、营养不良和肾功能不全等局部和全身情况有关。针对病因的去除或是改善是糖尿病足创面治疗的...糖尿病足是糖尿病最严重的慢性并发症之一,具有较高的致残率和致死率,其发病机制十分复杂,与外周神经病变和下肢动脉缺血有关,也与外伤、感染、营养不良和肾功能不全等局部和全身情况有关。针对病因的去除或是改善是糖尿病足创面治疗的关键部分,但是采取方法促进糖尿病足创面的愈合以改善糖尿病患者的预后也是当前医学界关注的焦点。以自体植皮为代表的人体自体成分在创面治疗中发挥重要作用。近年来,人体自体成分在糖尿病足创面的应用及研究不断涌现,在促进糖尿病足创面愈合等方面取得了良好的疗效。Diabetic foot is one of the most serious chronic complications of diabetes, with high disability and mortality rates. Its pathogenesis is very complex and is related to peripheral neuropathy and lower extremity arterial ischemia, as well as local and systemic conditions such as trauma, infection, malnutrition and renal insufficiency. Removing or improving the cause is the key part of diabetic foot wound treatment, but taking methods to promote the healing of diabetic foot wounds to improve the prognosis of diabetic patients is also the focus of current medical attention. Human autologous components represented by autologous skin grafts play an important role in wound treatment. In recent years, the application and research of human autologous components in diabetic foot wounds have continued to emerge, and have achieved good therapeutic effects in promoting the healing of diabetic foot wounds.展开更多
文摘糖尿病足是糖尿病最严重的慢性并发症之一,具有较高的致残率和致死率,其发病机制十分复杂,与外周神经病变和下肢动脉缺血有关,也与外伤、感染、营养不良和肾功能不全等局部和全身情况有关。针对病因的去除或是改善是糖尿病足创面治疗的关键部分,但是采取方法促进糖尿病足创面的愈合以改善糖尿病患者的预后也是当前医学界关注的焦点。以自体植皮为代表的人体自体成分在创面治疗中发挥重要作用。近年来,人体自体成分在糖尿病足创面的应用及研究不断涌现,在促进糖尿病足创面愈合等方面取得了良好的疗效。Diabetic foot is one of the most serious chronic complications of diabetes, with high disability and mortality rates. Its pathogenesis is very complex and is related to peripheral neuropathy and lower extremity arterial ischemia, as well as local and systemic conditions such as trauma, infection, malnutrition and renal insufficiency. Removing or improving the cause is the key part of diabetic foot wound treatment, but taking methods to promote the healing of diabetic foot wounds to improve the prognosis of diabetic patients is also the focus of current medical attention. Human autologous components represented by autologous skin grafts play an important role in wound treatment. In recent years, the application and research of human autologous components in diabetic foot wounds have continued to emerge, and have achieved good therapeutic effects in promoting the healing of diabetic foot wounds.
文摘目的:阐明锌-α2-糖蛋白(Zinc-α2-glycoprotein,ZAG)与胰岛素抵抗的关系以及胰升糖素样肽1(glucagon-like peptide-1,GLP-1)受体激动剂治疗的影响。方法:新发2型糖尿病(newly diagnosed T2DM,n T2DM)患者120例随机分为利拉鲁肽组(n=45,利拉鲁肽0.6~1.8 mg,i H qd)、利拉鲁肽+二甲双胍组(n=45,利拉鲁肽0.6~1.8 mg,i H qd+二甲双胍0.5g bid)、安慰剂组(n=30,生理盐水150μl i H qd+二甲双胍0.5g bid),治疗12周,同期选取年龄、性别相匹配的健康体检者作为健康对照组(n=30)。治疗前后分别行75g OGTT、胰岛素钳夹试验并检测血浆ZAG、脂联素(adiponectin,ADI)水平及相关代谢指标。结果:n T2DM患者基础血浆ZAG水平明显低于健康对照组(P<0.01),通过利拉鲁肽、利拉鲁肽+二甲双胍治疗后12周,患者的糖化血红蛋白,空腹血糖,糖负荷后2 h血糖,甘油三酯和稳态模型评估胰岛素抵抗指数均较治疗前明显下降(P<0.05),通过安慰剂治疗后上述指标明显高于利拉鲁肽治疗组(P<0.05);而在钳夹过程中,M值明显升高(P<0.01)。此外,与治疗前相比,利拉鲁肽治疗后血浆ZAG、ADI水平明显增加(P<0.01)。结论:n T2DM患者经GLP-1受体激动剂治疗后,糖代谢及胰岛素敏感性得到明显改善,血浆ZAG水平也明显升高,提示ZAG将可能被作为代谢综合征或者T2DM的一个新的生物标志物。
