糖尿病大鼠深Ⅱ度烫伤创面新生血管形成障碍的研究  

Study of neovaseularization disturbance in deep partial-thickness scald in rats with diabetes mellitus

作　　者：乔亮[1] 王志勇[1] 韦俊[1] 原博[1] 金曙雯[1] 花兰女[1] 廖镇江[1] 史济湘[1] 陆树良[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院烧伤科,200025

出　　处：《中华烧伤杂志》2008年第1期18-21,共4页Chinese Journal of Burns

基　　金：国家自然科学基金（30471784、30570705、30600645）

摘　　要：目的了解有糖尿病基础的机体烫伤后，创面新生血管化程度与创面难以愈合的关系。方法将sD大鼠分成对照组和以链脲佐菌素诱导的糖尿病组，每组50只。2组大鼠均造成20％TBSA的深Ⅱ度烫伤，于伤后即刻及1、3、7、14和21d取创面组织，行组织学观察评分，并计算创面愈合率；同时采用免疫荧光双标记法检测创面组织的新生血管化程度及血管内皮细胞数量。结果糖尿病组大鼠创面组织评分及创面愈合率均低于对照组；糖尿病组大鼠各时相点新生血管化程度较对照组明显降低（伤后7d，糖尿病组为12．00±1．40、对照组为60．00±3．00，P〈0．01）。2组大鼠各时相点创面血管内皮细胞数量差异不明显，但糖尿病组大部分血管内皮细胞未形成功能性微血管。结论糖尿病深Ⅱ度烫伤难愈创面虽血管内皮细胞增殖活跃但仍血供不良，其机制与功能性微血管形成障碍有关。Objective To study the relationship between the degree of neovascularization and nonhealing wounds in scalded rats with diabetic mellitus. Methods Sixty Sprague-Dawley rats were randomly divided into control group（ C, n = 30, with treatment of isotonic saline） and streptozocin （STZ） -induced diabetic group（ D, n = 30,with treatment of STZ ）, and then they were inflicted with 20% TBSA deep partial thickness scald. Wound specimens were harvested immediately after scald and on 1 , 3, 7, 10,14 ,21 post scald days （PSD） to observe histological changes, and wound healing rates were calculated. Degree of neovascularization in wound （labeled with blue microsphere）and the quantity of vascular endothelial cells （labeled with red CD31 ） were also measured by double-labeling immuofluoresence. Results Compared with those in C group , Wound healing rate and histological value scores were lowered ,and the degree of neovascularization was abated markedly at each time point. The degree of neovascularization in D group（ 12.00 ± 1.40） was obviously lower than that in C group on 7 PSD （60.00 ± 3.00, P 〈 0.01 ）. There was no obvious difference in the number of vascular endothelial cells in both groups , however , the majority of endothelial cells had not formed functional capillaries in D group. Conclusion Vascular endothelial cell can proliferate actively with poor blood supply in diabetic nonhealing with deep partial-thickness scald wounds,but it is still poor in blood supply due to lack of functional capillaries.

关 键 词：烧伤 糖尿病 新生血管化 病理性 内皮细胞 难愈创面 

分 类 号：R587.1[医药卫生—内分泌] R644[医药卫生—内科学]