| Objective:Through clinical experiment,observation and evaluation of platelet rich plasma(PRP)for the treatment of diabetic foot ulcer,using western blot and elisa,study the effect of PRP on the expression of LC3,P62,il-6,il-10 in granulation tissue of diabetic foot ulcer,and explore its regulation on autophagy and inflammatory response in diabetic foot ulcer,In order to provide more theoretical basis and research direction for PRP treatment of diabetic foot.Methods:1.30 patients with diabetic foot who were hospitalized in the department of plastic and burns surgery,affiliated hospital of north sichuan medical college and met the relevant inclusion and exclusion criteria from September 2018 to November 2019,were randomly divided into PRP treatment group and control group,with 15 cases in each group.Patients in both groups received standard medical treatment and wound clearance.Patients in the PRP group were treated with PRP gel covering wound surface after debridement,while patients in the control group were covered with saline gauze and vaseline gauze.2.Clinical part:the wound healing rate on the seventh,fourteenth and twenty-first day after treatment,VAS pain score for five consecutive days after treatment,and wound healing time of the two groups were compared.3.laboratory part:the expression levels of LC3 and P62 proteins in the granulation tissue of the wound before treatment,21 days after treatment were compared by western blot,and the changes of i1-6 and i1-10 were compared by elisa.4.SPSS 23 was used for data analysis,and P<0.05 was statistically significant.T test was used for measurement data between two samples,and chi-square test was used for counting data.a=0.05,P<0.05 was considered statistically significant.Result:1.Patients in the PRP treatment group and the control group had no adverse reactions and no related complications.2.VAS pain scores in both groups showed an overall decline.From third day,there was a statistically significant difference between the PRP group and the control group,with a lower VAS pain score in the PRP group(P<0.05).3.The wound of patients in the two groups showed a healing trend on the whole,among which 3 patients in the PRP group received skin grafting before twenty-first day.The wound healing rates of the PRP group were(0.204±0.054,0.314±0.038,0.396±0.014)on the seventh,fourteenth and twenty-first day,which were significantly higher than those of the control group(0.122±0.027,0.164±0.018,0.204±0.013)with statistically significant results(P<0.05).4.The healing time of PRP group was(31.40±4.47)days,significantly lower than that of control group(43.20±5.03)days,with statistically significant results(P<0.05).5.Western blot results showed that the gray value of LC3 protein in the wound granulation tissue of the PRP group after treatment(0.6805±0.0737)was significantly higher than that before treatment(0.3692±0.0471)(P<0.05),and the gray value of lc3-ii/lc3-i after treatment(1.6984±0.1283)was higher than that before treatment(0.6913±0.1133)(P<0.05).The gray value of P62 protein after treatment(0.4431±0.0396)was lower than that before treatment(0.7361±0.0556)(P<0.05).The gray values of LC3 and P62 proteins in the control group showed no significant difference before and after treatment(P>0.05).After treatment,autophagy level of the wound increased in the PRP group,while no statistically significant change was observed in the control group.6.Elisa showed that the concentration of IL-6(0.9174±0.1296 pg/ml)in the granulation tissue of PRP group was lower than that before treatment(1.3118±0.1817 pg/ml)(P<0.05).There was no statistical difference before and after treatment in the control group.The concentration of IL-10 increased in both groups after treatment(P<0.05),but the concentration(1.5801±0.072 pg/ml)in the PRP group was higher than that in the control group(1.5044±0.4429 pg/ml)(P<0.05).Conclusion:1.PRP has a good effect in treating diabetic foot ulcer without adverse reactions.It has the advantages of easy operation,reducing pain,accelerating wound healing and shortening healing time.2.In patients with diabetic foot treated with PRP,LC3 protein expression level in wound granulation tissue increased,lc3-ii/lc3-i increased,P62 protein expression level decreased,and autophagy level increased.3.PRP may accelerate the healing of diabetic foot ulcers by increasing the level of autophagy.4.PRP can inhibit the accumulation of inflammatory factors and improve the microenvironment of diabetic foot,which may be induced by autophagy. |
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