rhGM-CSF凝胶对烧伤后残余创面愈合的影响  

Effects of rhGM-CSF hydrogel on the healing of residual burn wound surface

作　　者：邱学文[1] 王甲汉[1] 杨磊[1] 任加良[1] 

机构地区：[1]南方医科大学南方医院烧伤科,广州510515

出　　处：《解放军医学杂志》2011年第8期817-820,共4页Medical Journal of Chinese People's Liberation Army

摘　　要：目的探讨局部应用重组人粒细胞巨噬细胞集落刺激因子（rhGM-CSF）凝胶对烧伤后残余创面愈合的影响。方法采用随机、双盲、安慰剂同体对照的方法,将138处烧伤后残余创面随机分为试验组（n=69）和对照组（n=69）。试验组采用rhGM-CSF凝胶治疗,对照组采用空白基质安慰剂治疗,周期21d。观察创面愈合时间、疗效及用药后7、14d的创面愈合率;选取6例患者,于用药后7、14d留取组织标本,观察创面肉芽组织中毛细血管数和成纤维细胞数。结果本研究共入组69例,脱落9例,纳入统计分析者60例。试验组创面愈合的中位时间为12d（95%CI 11~13d）,较对照组（18d,95%CI 17~19d）明显缩短（P〈0.001）,且试验组疗效明显优于对照组（P〈0.001）。用药7、14d后,试验组创面愈合率分别为62%±13%、95%±10%,均显著高于对照组（46%±11%、83%±12%,P〈0.001）。用药7、14d后,试验组创面肉芽组织中毛细血管数分别为10.3±0.61、4.5±0.9,均显著高于对照组（7.2±0.71、0.4±0.8,P〈0.001）,而成纤维细胞数分别为143.1±10.31、37.8±6.9,亦显著高于对照组（110.2±11.71、26.4±7.7,P〈0.01）。结论局部应用rhGM-CSF凝胶可促进烧伤后残余创面愈合,可能与其促进毛细血管生成及成纤维细胞增殖或迁移有关。Objective To investigate the effects of recombinant human granulocyte macrophage colony-stimulating factor（rhGM-CSF） hydrogel on the healing of residual burn wound surface.Methods One hundred and thirty-eight residual burn wound surfaces were assigned into experimental group and control group（69 each）,and randomized,double-blind,placebo-controlled and self-controlled clinical trials were conducted.The wound surfaces in experimental group were treated with rhGM-CSF hydrogel,and in control group with placebo,for 21 days.The healing time,therapeutic effects,and the healing rate of the wound surfaces at day 7 and day 14 after treatment were observed.The tissue samples were harvested from the border of the residual wounds from 6 patients on the 7th and 14th day after treatment,and the number of blood capillaries and fibroblasts was counted.Results Nine out of sixty-nine patients with residual burn wounds were excluded from the study,the data of only 60 patients were analyzed.The mean healing time of wounds was 12 days（95%CI 11-13 days） in experimental group,and it was significantly shorter than that in control group（18 days,95%CI 17-19 days,P0.001）;meanwhile the therapeutic effects of experimental group was significantly better than that of control group（P0.001）.The rate of healing in experimental group was 62%±13% and 95%±10%,respectively,on the 7th and 14th day after treatment,and they were significantly higher than that in control group（46%±11% and 83%±12%,respectively,P0.001）.At the 7th and 14th day after treatment,histopathological examination showed that the counts of capillaries（10.3±0.6/HP and 14.5±0.9/HP,respectively） and fibroblasts（143.1±10.3/HP and 137.8±6.9/HP,respectively） in experimental group were significantly higher than those in control group（capillaries： 7.2±0.7 and 10.4±0.8,P0.01;fibroblasts： 110.2±11.7 and 126.4±7.7,P0.01）.Conclusions Topical use of rhGM-CSF hydrogel may promote the healing of residual burn wounds,which maybe attributable to the

关 键 词：烧伤 粒细胞巨噬细胞集落刺激因子 重组 伤口愈合 

分 类 号：R644[医药卫生—外科学]