自体富血小板凝胶局部治疗静脉性溃疡临床疗效分析  

Clinical analysis of local treatment of autologous platelet-rich gel for venous ulcers

作　　者：丁伟佳[1] 胡检[1] 罗莞超[1] 江乐文[1] 陈茵[1] 

机构地区：[1]深圳市龙岗中心医院烧伤科,518116

出　　处：《中华损伤与修复杂志（电子版）》2012年第2期44-48,共5页Chinese Journal of Injury Repair and Wound Healing(Electronic Edition)

摘　　要：目的评价自制自体富血小板凝胶(APG)局部治疗静脉性溃疡的临床疗效并初步探讨其作用机制。方法筛选深圳市龙岗中心医院及协作单位收治的静脉性溃疡患者76例,入院经标准化治疗2周后随机分为两组,治疗组40例,对照组36例,两组患者的年龄、性别和病程比较差异均无统计学意义(P>0.05)。治疗组每2周于溃疡创面局部使用以自体外周静脉血制备的APG,传统方法换药;两组均观察至创面愈合。自治疗开始后每周1次测量创面面积,连续5周,并计算溃疡创面愈合率;对照组单纯按照传统方法换药。记录两组创面愈合时间;测定创面组织液中转化生长因子-β1、血小板源性生长因子-BB、表皮生长因子水平;在测量创面面积同时做溃疡组织活检,以histopathologicalcriteria评分行组织病理学分析。结果治疗组创面愈合时间为(38.69±5.72)d,较对照组的(50.17±4.94)d明显缩短(P=0.0339)。治疗组与对照组在第1、2、3、4、5周时间点创面愈合率相比明显增加[分别为(64.61±2.31)%vs(40.24±1.73)%,P=0.0179;(77.24±2.16)%vs(50.84±1.71)%,P=0.0108;(84.24±1.98)%vs(63.74±1.28)%,P=0.0217;(91.38±1.74)%vs(76.24±1.81)%,P=0.0029;(98.45±1.21)%vs(82.35±1.78)%,P=0.0205]。治疗组组织病理学评分亦明显高于对照组,创面组织中除表皮生长因子外,血小板源性生长因子-BB及转化生长因子-β1水平均明显高于对照组。结论 APG能明显促进静脉性溃疡创面愈合,其机制可能与APG增加创面局部生长因子水平,调控创面细胞的增殖、分化以及炎症的消退相关。Objective To evaluate the clinical effects of local treatment of autologous platelet-rich gel （APG） for venous ulcers and to explore its mechanism of actions. Methods Seventy-six patients with venous ulcers screened out in the authors＇ hospital and other cooperative units were randomly divided into a treatment group of 40 cases and a control group of 36 cases after two weeks of standard hospitalized treatment, with no significant difference in age, gender or course of disease between them. APG made from peripheral venous blood was administered on local ulcers of the treatment group biweekly whereas traditional dressing was applied to the control group until the ulcers were healed in both groups. The ulcer areas were measured, their healing rates were calculated, their healing time was recorded, and the levels of transforming growth factor -β1, latelet-derived growth factor and epidermal growth factor in the ulcer fluid were measured weekly from the start of the treatment for five consecutive weeks. Ulcer biopsy was made on all patients while their ulcer areas being measured for pathological analysis by the score lines of the histopathological criteria. Results The healing time in treatment group was （38 ± 5.72） days, and was significantly shorter than that in control group,which was （50 ± 4.94 ） days （ P = 0. 0339 ）. Compared with those in control group, the healing rates of ulcers in treatment group were increased greatly at each time point of the 1st, 2nd, 3rd, 4th and 5th week [（64.61 ±2.31）% vs （40.24±.73）%, P=0.0179; （77.24±2. 16）% vs （50.84± 1.71）%,P=0.0108; （84.24±.98） vs （63.74±.28）%,P=0.0217; （91.38±.74） vs （76.24±1.81 ） %, P =0. 0029 ; （98.45 ±1.21 ） % vs （ 82. 35 ±1.78 ） %, P = 0. 0205 ]. In addition to epidermal growth factor, the levels of platelet-derived growth factor-BB and transforming growth factor-J31 and the histopathological scores were also significantly higher than those of the control group. Conclusions APG can signific

关 键 词：富血小板血浆 静脉曲张溃疡 细胞因子类 

分 类 号：R654.3[医药卫生—外科学]