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目的:观察高压氧联合硫辛酸综合治疗对糖尿病足患者缺氧诱导因子、血管内皮因子的影响，分析其对截肢的预防作用。方法:选取山东省临沂市中心医院2016年6月至2019年6月内分泌科84例糖尿病足患者作为研究对象，按随机数字表法分为对照组和观察组，每组42例。在常规治疗基础上，对照组患者静脉滴注硫辛酸，剂量为0.6 g/250 ml，1次/d；观察组在对照组基础上联合高压氧综合治疗。比较2组患者治疗前后血清缺氧诱导因子-1α(hypoxia inducible factor-1α，HIF-1α)、内皮素-1(endothelin-1, ET-1)、一氧化氮(nitric oxide, NO)及血管内皮生长因子(vascular endothelial growth factor, VEGF)的变化，并记录截肢的发生情况。结果:治疗后，2组患者HIF-1α、ET-1、NO、VEGF水平均较治疗前降低，且观察组HIF-1α、ET-1、VEGF水平明显低于对照组(n P<0.05)。观察组患者截肢发生率为9.52%，低于对照组的21.43%。ROC曲线分析显示HIF-1α、ET-1/NO比值、VEGF预测截肢的临界值分别为317.5 pg/ml、1.977及29.012 5 pg/ml。HIF-1α对预测发生截肢的特异度为85.9%，优于ET-1/NO比值和VEGF的特异度(80.3%和76.4%)。n 结论:高压氧联合硫辛酸综合治疗能明显降低糖尿病足患者HIF-1α、ET-1、NO、VEGF水平，且HIF-1α预测发生截肢准确性较高，可帮助减少并预防截肢的发生。“,”Objective:To observe the mechanism of hyperbaric oxygen combined with lipoic acid in treating diabetic foot patients, and analyze its preventive effect on amputation as the adverse outcome.Methods:A total of 84 patients with diabetic foot admitted to the Department of Endocrinology of Linyi Central Hospital from June 2016 to June 2019 were selected as research objects and randomly divided into control group (n n=42) and observation group (n n=42). The patients in the control group received intravenous infusion of lipoic acid (0.6 g/250 ml, 1 time/d) on the basis of conventional treatment, while the patients in the observation group received hyperbaric oxygen therapy on the basis of the treatment in the control group. The levels of hypoxia inducible factor-1 (HIF-1α), endothelin-1 (ET-1), nitric oxide (NO) and vascular endothelial growth factor (VEGF) in serum before and after treatment were compared between the two groups. The occurrence of amputation as the adverse outcome was also recorded.n Results:After treatment, the levels of HIF-1α, ET-1, NO, and VEGF in both groups decreased, and the levels of HIF-1α, ET-1, and VEGF in the observation group were significantly lower than those of the control group (n P<0.05). The incidence of amputation as the adverse outcome in the observation group (9.52%) was lower than that of the control group (21.43%). Analysis of the receiver operating characteristic (ROC) curve showed that the threshold value of HIF-1α, ET-1/NO ratio, and VEGF for predicting amputation as the adverse outcome were 317.5 pg/ml, 1.977, and 29.0125 pg/ml, respectively. The specificity of HIF-1α for predicting amputation occurrence was 85.9%, which was better than those of ET-1/NO ratio (80.3%) and VEGF (76.4%).n Conclusion:Hyperbaric oxygen combined with lipoic acid can significantly reduce the levels of HIF-1α, ET-1, NO, and VEGF in patients with diabetic foot. HIF-1α has a relatively high accuracy in predicting the occurrence of amputation, which can help to reduce or prevent the occurrence of amputation as the adverse outcome.