炎症与修复相关细胞因子基因在临床慢性难愈性创面中差异表达的分析  

Analysis of differential gene expressions of inflammatory and repair-related factors in chronic refractory wounds in clinic

作　　者：汪涟 郭菲[2] 闵定宏[2] 廖新成[2] 余绍青[3] 龙星星 丁香 郭光华[2] Wang Lian;Guo Fei;Min Dinghong;Liao Xincheng;Yu Shaoqing;Long Xingxing;Ding xiang;Guo Guanghua(Graduate School of Nanchang University, Nanchang 330006, China;Burn Center of the First Affiliated Hospital of Nanchang University, Nanchang 330006, China;Graduate School of Nanchang University, Nanchang 330006, China)

机构地区：[1]南昌大学研究生院,南昌330006 [2]南昌大学第一附属医院烧伤中心,南昌330006 [3]南昌大学第一附属医院老年科,南昌330006

出　　处：《中华烧伤杂志》2019年第1期18-24,共7页Chinese Journal of Burns

基　　金：国家自然科学基金(81772083);江西省教育厅重点项目(700056003);江西省卫生计生委科技计划 (20171061);南昌大学研究生创新专项基金(CX2017250).

摘　　要：目的比较压疮和糖尿病足等慢性难愈性创面组织形态及炎症与修复相关细胞因子基因表达差异。方法收集2016年8月—2017年9月,南昌大学第一附属医院收治的10例泌尿外科行包皮环切术患者[均为男性,年龄(38±4)岁]10个包皮样本为正常皮肤组,9例热力或电烧伤患者[男6例、女3例,年龄(51±8)岁]、13例压疮患者[男9例、女4例,年龄(51±14)岁]、10例糖尿病足患者[男8例、女2例,年龄(61±10)岁]手术过程中切除的有血运创缘组织样本,分别为烧伤创面组(9个样本)、压疮组(13个样本)、糖尿病足组(10个样本)。取压疮组和糖尿病足组各10张切片,各取5张切片采用免疫荧光法观察组织形态及创面Ki67和CD31表达情况。取正常皮肤组10个样本、烧伤创面组9个样本、压疮组13个样本、糖尿病足组10个样本行实时荧光定量反转录PCR分析血管内皮生长因子192(VEGF192)、转化生长因子β(TGF-β)、血管细胞黏附分子1(VCAM-1)、细胞间黏附分子1(ICAM-1)、白细胞介素1β(IL-1β)、IL-6、肿瘤坏死因子α(TNF-α)的mRNA表达。对数据行Mann-WhitneyU检验、Kruskal-Wallis秩和检验。结果(1)糖尿病足组创面Ki67表达水平(390±100)高于压疮组创面(182±14,Z=-2.611,P<0.01)。(2)糖尿病足组创面虽然有大量血管内皮细胞(CD31阳性细胞)存在,但其分布无序,未形成完整管腔。压疮组创面血管内皮细胞数量远少于糖尿病足组创面,但形成完整管腔。(3)烧伤创面组、压疮组、糖尿病足组创面的VEGF192的mRNA表达水平均低于正常皮肤组(H=13.72、30.50、15.20,P<0.05或P<0.01),尤以压疮组表达水平最低;压疮组创面VEGF192的mRNA表达水平明显低于糖尿病足组(H=15.30,P<0.01)。与正常皮肤组比较,烧伤创面组创面TGF-β的mRNA表达水平无明显变化(H=-9.50,P>0.05),而压疮组、糖尿病足组创面TGF-β的mRNA表达水平明显降低(H=18.04、14.50,P<0.01);压疮组创面TGF-β的mRNA表达水平与糖ObjectiveTo compare the tissue morphology and gene expressions of inflammatory and repair-related factors in chronic refractory wound tissue including pressure ulcers and diabetic feet.MethodsDuring August 2016 to September 2017, 10 samples of prepuce were collected after circumcision of 10 urological patients [all male, aged (38±4) years old] admitted in the First Affiliated Hospital of Nanchang University and included in normal skin group, samples of tissue around the edge of wounds with blood supply were collected from 9 heat or electric burn patients [6 male patients, 3 female patients, aged (51±8) years old], 13 pressure ulcer patients [9 male patients, 4 female patients, aged (51±14) years old] and 10 diabetic foot patients [8 male patients, 2 female patients, aged (61±10) years old] during the operations. The samples were divided into burn wound group (9 samples), pressure ulcer group (13 samples), and diabetic foot group (10 samples). Ten slices were taken from pressure ulcer group and diabetic foot group respectively, and 5 slices in each group were used to observe the tissue morphology and expressions of Ki67 and CD31 of wounds respectively with immunofluorescence method. Ten samples from normal skin group, 9 samples from burn wound group, 13 samples from pressure ulcer group, and 10 samples from diabetic foot group were collected for analysis of mRNA expressions of vascular endothelial growth factor 192 (VEGF192), transforming growth factor β (TGF-β), vascular cell adhesion molecule-1 (VCAM-1), intercellular adhesion molecule-1 (ICAM-1) , interleukin-1β (IL-1β), IL-6, and tumor necrosis factor α (TNF-α) by real time fluorescent quantitative reverse transcription polymerase chain reaction. Data were processed with Mann-Whitney U test and Kruskal-Wallis rank-sum test.Results(1) The expression level of Ki67 in diabetic foot group (390±100) was higher than that of pressure ulcer group (182±14, Z=-2.611, P<0.01). (2) Although there were a large number of vascular endothelial cells (CD31 positive

关 键 词：压力性溃疡 糖尿病足 细胞因子类 基因表达 慢性难愈性创面 

分 类 号：R641[医药卫生—外科学]