Clinical effect of autologous bone marrow stem cell transplantation combined with ozagrel on diabetic foot

Abstract

Objective To evaluate the clinical effects of autologous bone marrow stem cell transplantation combined with ozagrel on diabetic foot (DF). Methods 99 patients with DF admitted to our hospital from July 2017 to August 2018 were enrolled for the study and randomly divided into ozagrel group, transplantation group and combination group (autologous bone marrow stem cell transplantation combined with ozagrel) (n = 33 in each group). All patients were given routine treatment. The changes of clinical symptoms, signs, severity of DF and quality of life before and 12 weeks after intervention, as well as the classification of new collateral vessels at 12 weeks after intervention were compared between groups. Qualitative data were analyzed by chi-square test or Wilcox rank test. Paired t-test was used for comparison of quantitative data before and after intervention. Variance analysis was used for comparison in multiple groups, and then Tukey test was used for comparison between groups. Pearson correlation coefficient was used to explore the related factors of quality of life score in amputated group. Results There were no significant differences in baseline data, scores of pain, chills, intermittent claudication, ankle-brachial index (ABI), Wagner grade, and diabetes-specific quality of life scale (DSQL) among three groups (P > 0.05). For intra-group comparison, the scores of pain, chills, intermittent claudication, DSQLdimensions scores of physiological function, psychological/mental factors, social relations and total scores after intervention among three groups were significantly lower than those before intervention, Wagner grade and ABI were significantly improved after intervention (P < 0.05). For inter-group comparison, the scores of pain, chills, intermittent claudication, DSQLdimensions scores of physiological function, psychological/mental factors and total scores after intervention in combination group were 0.83±0.36, 0.83±0.31, 1.36±0.63, 8.9±3.2, 7.5±2.5, and 23.7±9.2, and were significantly lower than those of in the ozagrel group (1.13±0.39, 1.26±0.59, 1.89±0.73, 12.5±5.2, 10.1±3.1, 31.7±8.8) and those of in the transplantation group (1.08±0.33, 1.11±0.55, 1.72±0.60, 10.9±3.6, 9.3±3.3, and 28.8±7.6) (F = 5.001, 5.598, 3.953, 2.230 and 9.610, P < 0.05). The ABI after intervention in the combination group was 0.55±0.21, and significantly higher than in that of the ozagrel group (0.43±0.20) and that of the intransplantation group (0.42±0.16) (F = 4.051, P < 0.05). The social relationship dimension score and ratio of Wagner grade 1 after intervention in the combined group were 5.0±2.1 and 81.8%, significantly higher than those of the ozagrel group (6.3±2.3, 54.5%) (P < 0.05). The classification of new collateral vessels after intervention in the combination group was significantly better than that in the ozagrelgroup (F = 3.953, χ2= 6.983, P < 0.05). Conclusions Autologous bone marrow stem cell transplantation combined with ozagrel could significantly alleviate the clinical symptoms of DF patients, promote ulcer healing and angiogenesis after transplantation, and improve the quality of life, which is worthy of clinical application. Key words: Autologous bone marrow stem cell transplantation; Ozagrel; Diabetic foot; Angiogenesis