2020 年第 3 期 第 15 卷

单波长红外线/红光治疗对糖尿病足患者皮肤缺氧诱导因子1α和血管内皮生长因子表达的影响

Effect of single wavelength infrared/red light therapy on skin hypoxia inducible factor-1α and vascular endothelial growth factor expression in patients with diabetic foot

作者：林楚佳蓝尤冕欧妙琼杨晓平鄞国书林少达

英文作者：

单位：汕头大学医学院第一附属医院内分泌科515041

英文单位：

关键词：糖尿病足；缺氧诱导因子1α；血管内皮生长因子；红外线；红光

英文关键词：

• 摘要：

• 【摘要】目的    探讨单波长红外线/红光治疗对糖尿病足患者皮肤缺氧诱导因子1α（HIF-1α）和血管内皮生长因子（VEGF）表达的影响。方法    选择2017年6月至2018年10月在汕头大学医学院第一附属医院住院的糖尿病足患者50例作为糖尿病足组，同时入选因下肢外伤行外科手术治疗的住院非糖尿病患者20例作为非糖尿病组。糖尿病足组按照随机数字表法分为常规治疗亚组和红外线/红光治疗亚组，各25例。常规治疗亚组给予常规营养神经、改善微循环治疗，红外线/红光治疗亚组在此基础上给予单波长红外线/红光光能照射治疗，2组均治疗14 d。比较2亚组治疗后临床疗效。采用免疫组织化学法观察患者皮肤微循环结构特点及HIF-1α、VEGF表达强度，酶联免疫吸附试验法检测皮肤组织匀浆中HIF-1α、VEGF水平，荧光定量聚合酶链反应检测皮肤组织匀浆中HIF-1α mRNA、VEGF mRNA水平。结果    红外线/红光治疗亚组治疗14 d后总有效率明显高于常规治疗亚组［84.0%(21/25)比52.0%(13/25)］（P＜0.05）。糖尿病足组皮肤真皮乳头及微血管密度，真皮层HIF-1α和VEGF平均吸光度值，皮肤组织匀浆中HIF-1α、VEGF水平及相关mRNA表达水平均低于非糖尿病组，红外线/红光治疗亚组治疗后各指标均明显高于常规治疗亚组［（80±16）个/mm2比（72±13）个/mm2、（165±17）条/mm2比（137±19）条/mm2、（0.378±0.052）比（0.164±0.031）、（0.88±0.09）比（0.62±0.11）、（2.15±0.37）μg/L比（1.12±0.18）μg/L、（13.0±1.6）μg/L比（11.8±1.4）μg/L、（3.36±0.81）比（2.02±0.27）、（7.2±1.7）比（5.8±0.5）］（均P＜0.05）。糖尿病足患者治疗前皮肤真皮乳头平均微血管密度与皮肤真皮层HIF-1α、VEGF平均吸光度值，皮肤组织匀浆HIF-1α、VEGF水平及HIF-1α mRNA和VEGF mRNA水平均呈正相关（均P＜0.05）。结论    单波长红外线/红光治疗可提高糖尿病足患者皮肤组织中HIF-1α、VEGF表达水平，改善皮肤微循环结构，提高糖尿病足溃疡治愈率。

  
  

• 【Abstract】Objective    To observe the effect of single wavelength infrared/red light therapy on expressions of hypoxia inducible factor-1α(HIF-1α) and vascular endothelial growth factor(VEGF) in diabetic foot patients. Methods    From June 2017 to October 2018, 50 patients with diabetic foot and 20 non-diabetic patients who had surgical treatment for lower limb trauma in the First Affiliated Hospital of Shantou University Medical College were enrolled. Diabetic foot patients were randomly divided into routine group and infrared/red light group, with 25 cases in each group. The routine group had conventional nerve nutrition and microcirculation treatment. The infrared/red light group was treated with single wavelength infrared/red light irradiation on the basis of conventional treatment. Clinical efficacy was analyzed after 14 days of treatment. Skin microcirculation, HIF-1α and VEGF expression intensity were observed by immunohistochemical assay. Expression levels of HIF-1α, VEGF in skin tissue were detected by enzyme-linked immunosorbent assay and mRNA expressions were detected by fluorescence quantitative polymerase chain reaction. Results    The total effective rate in the infrared/red light group was significantly higher than that in the routine group［84.0%(21/25) vs 52.0%(13/25)］(P＜0.05). Dermal papilla microvessel density, absorbances of HIF-1α and VEGF in dermis, protein and mRNA expressions of HIF-1α and VEGF in skin homogenate in diabetic foot patients were lower than those in non-diabetic patients; the indexes were significantly improved after treatment and they were higher in the infrared/red light group than those in the routine group［（80±16）/mm2 vs （72±13）/mm2, （165±17）/mm2 vs （137±19）/mm2, （0.378±0.052） vs （0.164±0.031）, （0.88±0.09） vs （0.62±0.11）, （2.15±0.37）μg/L vs （1.12±0.18）μg/L, （13.0±1.6）μg/L vs （11.8±1.4）μg/L, （3.36±0.81） vs （2.02±0.27）, （7.2±1.7） vs （5.8±0.5）］（all P＜0.05）. Before treatment, dermal papilla microvessel density was positively correlated with absorbances of HIF-1α and VEGF in dermis, protein and mRNA expressions of HIF-1α and VEGF in skin homogenate(all P＜0.05). Conclusion    Single wavelength infrared/red light therapy can increase HIF-1α and VEGF expression in skin tissue, improve skin microcirculation and promote ulcer healing in diabetic foot.