1 冀中能源邢台矿业集团有限责任公司总医院骨科，河北 邢台 054000
2 冀中能源股份有限公司，河北 邢台 054000
3 邢台市人民医院整形烧伤科，河北 邢台 054000
4 邢台市第三医院生殖医学科，河北 邢台 054000
目的：评价脂肪干细胞(adipose-derived stem cells，ADSCs)局部注射治疗糖尿病慢性创面的临床效果。方法：选择诊断为糖尿病慢性溃疡难愈性创面患者100例，随机将其分为对照组与观察组(每组各50例)。对照组采用常规综合疗法，包括外科清创、无菌纱布覆盖和封闭负压引流；观察组同时在局部注射ADSCs，连续治疗4周。比较两组创面愈合率和感染率，治疗1周、2周和4周疼痛视觉模拟评分(Visual Analogue Score，VAS)和创面量化积分，检测创面边缘组织血管内皮生长因子(vascular endothelial growth factor，VEGF)表达和微血管密度。结果：观察组创面愈合率显著高于对照组，细菌感染率降低(P<0.05)。观察组治疗1周、2周和4周的疼痛VAS评分和创面量化积分均显著低于对照组(P<0.05)。观察组创面VEGF水平和微血管密度显著高于对照组(P<0.05)。结论：ADSCs局部注射治疗糖尿病慢性创面可提高创面愈合率，降低细菌感染，减轻疼痛，增加创面VEGF表达和微血管形成，有较好的应用安全性和有效性。
Clinical effect of adipose stem cells by local injection for chronic wound of diabetes mellitus
This work was supported by the Science and Technology Planning Project of Xingtai Hebei Province, China (2018Zc170).
Objective: To evaluate clinical effect of adipose-derived stem cells (ADSCs) local injection in treatment of chronic wound in diabetes mellitus patients. Methods: A total of 100 diabetic patients with chronic ulcer difficult healing wounds were enrolled and divided randomly into a control and an observation groups (50 cases for each). The control group received routine comprehensive therapy including surgical debridement, sterile gauze covering and closed negative pressure drainage, and the observation group adopted ADSCs local injection for continuous 4 weeks. Wound healing rate and infection rate, pain Visual Analogue Score (VAS) and wound quantitative integral were compared after 1, 2 and 4 weeks. Vascular endothelial growth factor (VEGF) expression and microvessel density in wound margin tissues were detected. Results: The wound healing rate in the observation group was significantly higher than that in the control group, and the bacterial infection rate was lower, there were statistically significant differences (P<0.05). What’s more, the pain VAS score and wound quantitative integral after 1, 2 and 4 weeks in observation group were more less (P<0.05). Furtherly, the wound VEGF level and microvessel density in observation group were higher, there was statistically significant difference (P<0.05). Conclusion: ADSCs local injection can improve wound healing rate, reduce bacterial infection, alleviate pain, increase wound VEGF expression and microvessel density formation in diabetic patients with chronic wounds, which is better safety and effectiveness.
adipose stem cells; diabetes mellitus; chronic wounds; vascular endothelial growth factor; microvessel