胰岛素局部应用对老龄糖尿病大鼠烫伤创面愈合的实验研究  

EFFECT OF INSULIN ON BURN WOUND HEALING IN AGING DIABETES MELLITUS RATS

作　　者：吴健[1] 薛晓东[1] 刘俊玲[1] 司小强[1] 杨国虎[1] 

机构地区：[1]甘肃省人民医院烧伤整形科,兰州730000

出　　处：《中国修复重建外科杂志》2009年第12期1482-1486,共5页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的观察局部应用胰岛素对老龄糖尿病(diabetes mellitus,DM)大鼠烫伤创面愈合的影响,探讨其可能的作用机制。方法SPF级Wistar老龄(12～24月龄)大鼠75只,雌雄不限,体重300～350g,随机分为3组,每组25只。A组为烫伤对照组,B组为DM烫伤对照组,C组为DM胰岛素治疗组。除A组外,B、C组大鼠经高脂、高蛋白、高糖饲养1个月后腹腔注射链脲佐菌素,建立老龄DM动物模型,同法饲养。DM模型制备8周后制备各组大鼠深Ⅱ度烫伤模型。A、B组创面局部注射灭菌生理盐水2mL,C组创面局部注射胰岛素0.1U,于伤后7、14、21d计算各组大鼠创面愈合率;伤后1、3、7、14、21d行HE染色观察,并检测创面组织糖含量、羟脯氨酸(hydroxyproline,HOP)含量,行CD34免疫组织化学染色观察并计算微血管密度(microvessel density,MVD)。结果伤后7、14、21d,A、C组创面愈合率明显高于B组,差异有统计学意义(P<0.05);A、C组间比较差异无统计学意义(P>0.05)。组织学观察见A组伤后21d,创面上皮基本上皮化;B组仍有大量坏死组织,创面未愈;C组创面上皮完全上皮化,上皮细胞分化较好,新生胶原较多。伤后1、3、7、14、21d A组创面组织糖含量明显低于B、C组,C组在伤后7、14、21d明显低于B组,比较差异均有统计学意义(P<0.05)。各时间点A、C组创面组织中HOP含量、MVD计数均明显高于B组,差异有统计学意义(P<0.05);A、C组间比较差异无统计学意义(P>0.05)。CD34表达:A组伤后7d呈+,14d呈++,21d呈+++;B组伤后14、21d呈+;C组伤后7d呈++,14、21d呈+++。结论局部应用胰岛素可促进创面胶原合成,增加创面的血管形成,加速老龄DM大鼠烫伤创面愈合。Objective To investigate the effect of topical application of insulin on the burn wound healing in aging diabetes mellitus （DM） rats and to explore its mechanism. Methods Seventy-five SPF Wistar rats （female and/or male）,aged 12-24 months and weighing 300-350 g,were selected and randomly divided into group A （burn control group,n=25）,group B （DM burn control group,n=25）,and group C （DM insulin treatment group,n=25）. The rats in group B and group C were fed with high-fat,high-protein,and high-sugar forage for 1 month and received intraperitoneal injection of streptozotocin （STZ） to establish experimental model of aging DM. The rats were fed with high-fat,high-protein,and high-sugar forage for another 8 weeks. Then,the deep second-degree burn model was established in the rats of group B and group C. The wounds in group A and B underwent local subcutaneous injection of 2 mL isotonic saline and group C received local subcutaneous injection of 0.1 U insulin. The rate of wound healing was calculated 7,14,and 21 days after burn injury. At 1,3,7,14,and 21 days after burn injury,HE staining observation,immunohistochemistry staining for CD34,detection of sugar and hydroxyproline （HOP） content in wound tissue,and microvessel density （MVD） calculation were performed. Results At 7,14,and 21 days after burn injury,the wound healing rates of group A and group C was significantly higher than that of group B （P 〈 0.05）,and there was no significant difference between group A and group C （P 〉 0.05）. Histology observation at 21 days after burn injury：in group A,certain degree of epithelization was evident in the wound epithelium; in group B,large quantity of necrotic tissue was evident; in group C,complete epithlization occurred in the wound epithelium with better epithelial cell differentiation and more neonatal collagen. For the sugar content in the wound tissue,group A was significantly lower than group B or group C at 1,3,7,14,and 21 days （P 〈 0.05） and group C was significantl

关 键 词：老龄糖尿病 烫伤 胰岛素 创面愈合 大鼠 

分 类 号：R587.1[医药卫生—内分泌] R644[医药卫生—内科学]