探讨自体骨髓干细胞移植联合奥扎格雷对糖尿病足（DF）的临床疗效。

选取2017年7月至2018年8月期间于重庆市大渡口区人民医院收治的99例DF患者为研究对象，随机分为奥扎格雷组、移植组与联合组3组各33例。全部患者入院后均给予DF的常规治疗，奥扎格雷组、移植组、联合组分别给予奥扎格雷、自体骨髓干细胞移植、自体骨髓干细胞移植联合奥扎格雷，比较干预前、干预后12周的临床症状体征、DF严重程度、生存质量的变化，以及干预后12周的新生侧支血管的分级情况。定性资料采用χ²检验或Wilcox秩和检验，定量资料组内干预前后比较采用配对t检验，多组比较先采用方差分析，然后采用Tukey检验进行两两比较。采用Pearson相关系数探讨截肢组患者生活质量评分的相关因素。

3组患者干预前的基线资料、疼痛、冷感、间歇性跛行的评分、踝肱指数（ABI）、Wagner分级、糖尿病特异性生活质量量表（DSQL）各维度评分与总分比较，差异无统计学意义（P > 0.05），具有可比性。组内比较，3组干预后的疼痛、冷感、间歇性跛行的评分、DSQL生理功能、心理（精神）因素、社会关系等维度评分与总分均低于干预前，Wagner分级、ABI优于干预前，差异有统计学意义（P < 0.05）。组间比较，联合组干预后的疼痛、冷感、间歇性跛行的评分、DSQL生理功能、心理（精神）因素等维度评分与总分分别为0.83±0.36、0.83±0.31、1.36±0.63、8.9±3.2、7.5±2.5、23.7±9.2，均低于奥扎格雷组的1.13±0.39、1.26±0.59、1.89±0.73、12.5±5.2、10.1±3.1、31.7±8.8及移植组的1.08±0.33、1.11±0.55、1.72±0.60、10.9±3.6、9.3±3.3、28.8± 7.6，差异有统计学意义（F = 5.001、5.598、3.953、2.230、9.610，P均< 0.05）。联合组干预后的ABI为0.55±0.21，高于奥扎格雷组的0.43±0.20及移植组的0.42±0.16，差异有统计学意义（F = 4.051，P < 0.05）。联合组干预后的社会关系维度评分、Wagner分级为1级的比例分别为5.0±2.1、81.8%，高于奥扎格雷组的6.3±2.3、54.5%，差异有统计学意义（F = 3.953，χ²= 6.983，P均 < 0.05）。观察组干预后的新生侧支血管分级优于奥扎格雷组，差异有统计学意义（P < 0.05）。

自体骨髓干细胞移植联合奥扎格雷能缓解DF患者的临床症状，促进溃疡愈合，促进移植术后的血管新生，提高生存质量，值得临床推广应用。

To evaluate the clinical effects of autologous bone marrow stem cell transplantation combined with ozagrel on diabetic foot (DF).

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.

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).

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.