藻酸盐敷料与mEGF联合应用促进难愈性创面表皮干细胞增殖  

Effects of alginate dressing and mouse epidermal growth factor combination therapy on epidermal stem cells in patients with refractory wound

作　　者：毕擎[1] 夏冰[1] 朱丹杰[1] 许励[2] 邱斌松[1] 徐文娟[2] 章水均[1] 洪剑飞[1] 

机构地区：[1]浙江省人民医院骨科,浙江杭州310014 [2]浙江省人民医院病理科,浙江杭州310014

出　　处：《中国病理生理杂志》2007年第11期2253-2257,共5页Chinese Journal of Pathophysiology

基　　金：浙江省医药卫生科学基金资助项目(No2002A011)

摘　　要：目的:探讨联合应用藻酸盐敷料(alginate dressing)与冻干鼠表皮生长因子(mEGF)对难愈性创面表皮干细胞(ESCs)增殖分化的影响,评价其疗效。方法:采用前瞻性、随机、对照设计。选择经常规换药抗炎治疗1个月仍未愈合创面18例。随机分成3组:藻酸盐凝胶与mEGF联合治疗组(A组)、mEGF治疗组(B组)、常规治疗组(C组),每组6例。治疗后7、14、21、28d评价其创面愈合指数,7d和14d时取组织活检做常规病理学观察,免疫组织化学SP法评定角蛋白10(CK10)和角蛋白15(CK15)表达阳性细胞数目。结果:A组和B组均能明显促进创面愈合,其中以A组疗效更加突出(P<0.05);A组创面修复细胞增殖明显,表皮增厚,上皮化活跃,B组虽也有类似改变但不如A组显著;A组和B组ESCs明显增多,增大,分层。上皮脚增多,呈多角状,以A组尤其明显,C组无明显变化。结论:藻酸盐凝胶与mEGF联合应用治疗难愈性创面,能更好地促进ESCs的增殖分化,较单用mEGF疗效更佳。AIM： To evaluate the effect of combination therapy with alginate dressing and mouse epidermal growth factor （mEGF） on proliferation and differentiation of epidermal stem cells （ ESCs ） in patients with refractory wound. METHODS： Eighteen cases, 12 males and 6 females, aged from 18 to 61 years （mean 36.4 years）, of skin defects therapy by dressing changing for one month were selected in this study. The wounds were 11 in the foot, 3 in the calf, 2 in the thigh and 2 in the forearm. All the patients were randomly divided into 3 groups： alginate dressing and mEGF group （n =6）, mEGF group （n =6） and control group （n =6）. The wound closure indexes were measured at 7th, 14th, 21st and 28th days. The samples were harvested at 7th and 14th days after treatment for pathologic examination. The positive staining cells of cytokeration 10 （CK10） and cytokeration 15 （ CK15 ） were evaluated by SP immunohistochemical staining technique. RESULTS： The wound healing was promoted in group A and group B. However, the wound closure index was increased in group A （P 〈0. 05）. Pathological examination showed the epidermis was thicker in group A than that in group B and C. Treatment by the alginate dressing combined with the mEGF, angiogenesis was active and granulation was enhanced. As compared with group B and group C, SP immuohistochemical staining technique showed that the ESCs in group A were bigger in size and larger in number. There was significant difference between group A and group B （or C） in the proliferation and differentiation of ESCs. CONCLUSION： Combined therapy with alginate dressing and mEGF shows a better result than that with mEGF only in proliferation and differentiation of ESCs of patients with refractory wound.

关 键 词：藻酸盐 表皮生长因子 干细胞 伤口愈合 

分 类 号：R363[医药卫生—病理学]