创面局部应用CTLA4Ig重组腺病毒延长异体皮移植存活期的临床应用  

Clinical application of CTLA4Ig-adenovirus for prolonging survival time of allograft skin on burn wound

作　　者：王锡华[1] 吴军[1] 陈希炜[1] 易绍萱[1] 罗高兴[1] 贺伟峰[1] 

机构地区：[1]第三军医大学西南医院全军烧伤研究所,创伤,烧伤与复合伤国家重点实验室,重庆400038

出　　处：《第三军医大学学报》2004年第19期1711-1713,共3页Journal of Third Military Medical University

基　　金：国家自然科学基金资助重点项目 ( 399934 30 2 ) ;国家自然科学基金资助面上项目 ( 39970 756 )~~

摘　　要：目的　观察创面局部应用CTLA4Ig重组腺病毒延长异体皮存活期的临床效果。方法　 12例大面积烧伤切痂创面应用CTLA4Ig重组腺病毒自体微粒皮和异体皮移植。临床观察异体皮存活时间、微粒皮封闭创面情况、用EP Ⅰ型水蒸仪测定创面水分蒸发量及组织学观察。结果　创面应用CTLA4Ig重组腺病毒能显著延长异体皮移植物的成活期 [对照组 ( 16.9± 3 .7)d ,实验组 ( 2 5 .6± 5 .5 )d] ,淋巴细胞浸润较少 ,自体微粒皮移植创面愈合率明显增高 ;实验部位水分蒸发量保持较低水平 ,而对照部位于术后 9d逐渐升高。结论　局部应用CTLA4Ig 重组腺病毒是一种有效延长烧伤创面异基因移植皮肤存活期的方法。Objective To observe the effects of CTLA4Ig-adenovirus on prolonging survival time of allograft skin on the local burn wound. Methods In 12 patients with major burn, the Ad-CTLA4Ig cream prepared with 0.48% carbomer was applied on the wounds after escharectomy, and then the auto-microskin graft and allograft skin were transplanted on the wound. The survival time, wound healing area by auto-microskin grafting, the evaporative water loss (EWL) through wound coverings, and the histological changes were observed. The control sites were not applied with the cream. Results Local administration of CTLA4Ig-adenovirus cream could prolong the survival time of alloskin graft on burn wound significantly [(16.9±3.7) d vs (25.6±5.5) d, P<0.01]. Wound healing rate by auto-microskin grafting in experimental sites was significantly higher (82.4%±14.2%) than that in the control sites (54.4%±19.7%). The EWL on experimental sites remained a low level, but EWL on the control sites increased gradually from the 9th day after operation. Lymphocyte infiltration of the allograft skin in the experimental sites was more serious than that in the control sites. Conclusion Local administration of Ad-CTLA4Ig is an effective and easy protocol for prolonging the survival time of alloskin graft on burn wound.

关 键 词：细胞毒性T淋巴细胞相关抗原4 烧伤 皮肤移植 免疫耐受 创面愈合 

分 类 号：R392.11[医药卫生—免疫学] R622.1[医药卫生—基础医学]