| Objective: To observe the effect of intensive blood glucose control treatment on the changes of serum exosomes miR-126-3P,miR-125b-1-3p and wound healing in diabetic patients with ulcer wounds.From the perspective of exosomal micro RNAs,to explore strengthening blood glucose control treatment to promote diabetic ulcer wounds The mechanism of healing.Methods: Collected the whole blood samples and wound tissues of 45 diabetic patients with ulcers on the first day and the tenth day of treatment,and divided them into the following two groups according to the actual clinical treatment situation: intensive blood glucose control group(21 cases),loose blood glucose control Group(24 cases);10 cases of normal human whole blood were selected as the control group.The collection of data is mainly divided into the following three parts: 1.The blood sample is centrifuged and the upper serum is stored in the refrigerator at-80°C.The laboratory extracts serum exosomes,conducts exosomal identification,and determines the relative expression levels of miR-126-3P and miR-125b-1-3p;2.The wound granulation tissue is collected and prepared with 10% formaldehyde fixative The wax block was preserved.The wound tissue samples were stained with HE in the laboratory to observe the pathological form and the number of blood vessels,and the expression of the vascular endothelial marker CD31 was observed by immunohistochemistry;3.Follow-up measurement,take pictures and record the wound healing of each patient,and collect patients Clinical data,follow up outside the hospital.Finally,the clinical data and laboratory results are combined with relevant statistics for statistical analysis.Results:(1)Gender,age,body mass index(BMI),fasting blood glucose(FBG),2h postprandial blood glucose(2h PBG),glycosylated hemoglobin A1c(Hb A1c),systolic blood pressure(SBP),diastolic blood pressure(DBP),albumin,globulin,blood creatinine,blood uric acid,cholesterol,triglycerides,low-density lipoprotein,white blood cells,percentage of neutrophils,and hemoglobin were not statistically different.(2)Intensified blood sugar control and conventional blood sugar control can reduce the inflammatory response indicators.The percentage of white blood cells and neutrophils after treatment improved compared with that before treatment, 00.05;and the leukocyte decline value and wound healing rate of the intensified blood sugar group were looser than those before treatment.Group is high,the difference is statistically significant,respectively 00.05 and 00.001;bbserved from the naked eye,the wound in the enhanced blood glucose group has less exudate and is easier to grow fresh granulation tissue;bbserve the granulation tissue from the pathological section,and the blood glucose intensified group the new microvessels and vascular marker CD31 are more densely distributed.(3)The successful extraction of serum exosomes was proved by the surface signal protein(CD9,TSG101,CD63)of exosomes(CD9,TSG101,CD63),nanoparticle tracer analysis(NTA),and transmission electron microscopy.The detection of miR-126-3P and miR-125b-The results showed that:(1)The healing rate of wounds was positively correlated with serum miR-126-3P and miR-125b-1-3p levels before and after treatment,<0.05,serum miR-126-3p and The higher the level of miR-125b-1-3p,the better the wound healing;(2)After treatment,the serum miR-126-3p level is negatively correlated with the fasting blood glucose level after treatment,and it is statistically significant,00.05,suggesting that after treatment The higher the fasting blood glucose level,the lower the serum miR-126-3p level;(3)The fasting blood glucose level before and after treatment and the postprandial blood glucose level after treatment are negatively correlated with wound healing rate,00.05,indicating that the higher the blood glucose level The more unfavorable the wound healing.(4)The serum levels of miR-126-3p and miR-125b-1-3p in patients with diabetic ulcer wounds are lower than those in normal people.After blood sugar control treatment,the levels of these two micro RNAs in serum increased significantly, 00.001;treatment the post-serum miR-126-3p level was significantly different between the intensive blood glucose and the conventional blood glucose,00.01,the level of the intensive group was significantly higher than that of the conventional group.(5)The wound prognosis of the intensive blood sugar control group was better than that of the conventional blood sugar control group,the difference was statistically significant,00.05.Conclusion: Intensified blood glucose treatment can increase the serum exosomal miR-126-3p level in patients with diabetic ulcer wounds,promote the regeneration of wound microvessels,and facilitate wound healing. |
