| Objective: Observed the difference of tissue fibronectin(FN)and plasma D-dimer levels in elderly patients with type 2 diabetic foot disease(DF),elderly patients with type 2 diabetes mellitus(T2DM)-foot trauma and elderly patients with foot injury(Non-DF and Diabetes).Changes in tissue FN content and plasma D-dimer levels between severity(according to Wagner classification),and observation of alprostadil injection combined with lipoic acid injection for the treatment of FN and plasma D-dimer in elderly patients with DF Impact and clinical efficacy.Method: 1.According to the order of treatment,60 elderly patients with DF(according to Wagner's classification,60 patients with I-IV)were randomly selected.60 elderly patients with T2DM-foot trauma and 60 elderly patients with foot injury were used to take ulcers or traumatic skin.Tissue and venous blood were measured by enzyme-linked immunosorbent assay(ELISA)method to measure the concentration of tissue FN and plasma D-dimer.2.60 elderly DF patients,according to the degree of illness according to Wagner classification was divided into: Wagner I-level patients in 14 cases,Wagner II-level patients in 18 cases,Wagner III-level patients in 16 cases,Wagner IV-level patients in 12 cases,comparing the organization of FN between levels Content and changes in plasma D-dimer levels.3.60 elderly patients with DF were randomly selected as the observation group according to the order of treatment.15 patients were treated with basic treatment plus alprostadil injection and lipoic acid injection;15 patients with senile DF were randomly selected as control group 1 and basic treatment was used.Treatment with alprostadil injection;Randomly selected 15 elderly DF patients as control group 2;treated with basal treatment + lipoic acid injection;randomly selected 15 elderly DF patients as control group 3,using basic treatment;Changes in tissue FN and plasma D-dimer levels and clinical therapeutic effect were compared between the four groups before and 2 weeks after treatment,and the total treatment efficacy of the observation group and the control group 1-3 group were analyzed.Result: 1.Compared with the elderly group with foot injury,the FN content in the ulcer tissue and the plasma D-dimer level in elderly patients with DF group and T2DM-foot trauma elderly group were decreased(P<0.05);the elderly with T2DM-foot injury Compared with the group of patients,the FN content in the ulcer tissue and the plasma D-dimer level in the elderly DF group were increased(P<0.05).2.Compared with Wagner I grade,tissue FN content decreased and plasma D-dimer level increased in Wagner II-IV grades(P<0.05);compared with Wagner II grade,tissue FN content decreased and plasma D-dimer level increased in Wagner III and IV grades(P<0.05).Compared with Wagner III grade,the content of FN in the tissue of Wagner IV was decreased and plasma D-dimer level was increased(P<0.05).3.Compared with before treatment,the FN level in the observation group and the control group 1-2 increased after treatment,and the plasma D-dimer level decreased(P<0.05),while the control group 3 group treated FN There was no significant change in plasma D-dimer levels(P>0.05).There was no significant change in FN and plasma D-dimer levels in the control group after treatment compared with the control group 1 group.P>0.05);Compared with the control group after treatment,the FN content in the observation group and the control group 1-2 after treatment increased,plasma D-dimer levels decreased(P<0.05);After treatment in the control group 1-2 group,the FN content in the observation group was higher after treatment,and the plasma D-dimer level was lower(P<0.05);At the same time,the total effective rate in the observation group was higher than that in the control group 1-3(P<0.05).Conclusion: 1.Tissue FN and plasma D-dimer may affect the healing of ulcer wounds in elderly DF patients.Tissue FN content and plasma D-dimer levels may be related to the severity of DF patients and the prognosis.2.The combination of alprostadil injection and lipoic acid injection in the treatment of senile DF patients can promote the healing of ulcer wounds.The combination therapy of the two drugs can increase the FN content of the ulcer tissue and decrease the plasma D-dimer level more than the single drug therapy,and the clinical efficacy is even better.Significantly,its mechanism of action may be to reduce the level of D-dimer,improve the body's hypercoagulability,and promote the repair of ulcer tissues by FN. |
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