清创后外用碱性成纤维细胞生长因子对新西兰兔结核性创面愈合的影响  

Effects of basic fibroblast growth factor on healing of Mycobacterium tuberculosis infective wound in New Zealand rabbit after debridement

作　　者：张同威 汪毅平 贾赤宇 Zhang Tongwei;Wang Yiping;Jia Chiyu(Department of Burns and Plastic Surgery,the Eighth Medical Center of PLA General Hospital,Beijing 100091,China;Department of Burns and Plastic Surgery,Xiang'an Hospital of Xiamen University,Xiamen 361102,China)

机构地区：[1]解放军总医院第八医学中心烧伤整形科,北京100091 [2]厦门大学附属翔安医院烧伤整形科,361102

出　　处：《中华烧伤杂志》2019年第2期95-103,共9页Chinese Journal of Burns

基　　金：国家自然科学基金面上项目(81372051);北京市科技计划(Z151100004015199).

摘　　要：目的探讨外用碱性成纤维细胞生长因子(bFGF)对新西兰兔结核性创面清创后愈合的影响。方法取32只3~4个月龄雌雄不拘新西兰兔,均于臀部皮内注射弗氏完全佐剂0.1 mL致敏,6周后于兔背部两侧注射浓度5×10^7集落形成单位/mL的牛型结核分枝杆菌减毒株菌液各0.5 mL,建立新西兰兔结核性创面模型。建模成功后,将32只兔按随机数字表法分为生长因子组、抗结核药物组、联合治疗组和空白对照组,每组8只。对创面进行彻底清创后,生长因子组兔创面均匀涂抹重组牛bFGF凝胶(300 IU/cm^2,每个创面约涂0.45g);抗结核药物组兔创面采用6mL异烟肼注射液和0.15g利福平粉针剂混匀浸透纱布后覆盖;联合治疗组兔创面同前用重组牛bFGF凝胶均匀涂抹后,用异烟肼和利福平浸透纱布覆盖;空白对照组兔创面仅用无菌纱布覆盖。各组隔日换药1次,至创面完全愈合。于术后即刻、7、14、21、28 d,肉眼观察创面大体情况,拍照并计算术后7、14、21、28 d的创面愈合率并记录创面完全愈合时间。术后7、14、21、28 d,取创缘组织行苏木精-伊红染色、Masson染色观察组织形态学情况。于术后21 d,取创缘组织采用免疫组织化学法行微血管计数。于术后7、14、21、28 d,采用酶联免疫吸附测定法检测创缘羟脯氨酸含量。以上实验样本数均为8。对数据行重复测量方差分析、析因设计方差分析、单因素方差分析、LSD检验及Bonferroni校正。结果(1)4组兔均存活至实验完成。术后即刻,4组兔创面基底水肿明显。术后7 d,4组兔创面较前缩小,创面覆盖痂皮,水肿减轻,其中生长因子组和联合治疗组兔创面组织更加红润。术后14 d,4组兔创面缩小明显,抗结核药物组和联合治疗组兔创面均无明显渗出;生长因子组兔1个创面和空白对照组兔2个创面红肿,有脓性分泌物。术后21 d,生长因子组、联合治疗组兔创面基本愈合,空白对照�Objective To investigate the effects of basic fibroblast growth factor (bFGF)on healing of Mycobacterium tuberculosis infective wound in New Zealand rabbit after debridement.Methods Thirtytwo New Zealand rabbits (3 to 4 months old,no matter male or female)were intradermally injected with 0.1 mL of complete Freund's adjuvant on the buttocks.Six weeks later,each rabbit was injected with 0.5 mL 5 ×10^7 colony forming unit/mL Bacillus Calmette-Guerin on both sides of the back to reproduce the model of Mycobacterium tuberculosis infective wound in New Zealand rabbit.After successful modeling,the 32 rabbits were divided into growth factor (GF)group,antitubereulosis drug (AD)group,combined treatment (CT) group,and blank control (BC)group according to the random number tab/e,with 8 rabbits in each group. After a complete debridement,the wounds of rabbits in group GF were treated with recombinant bovine bFGF gel (300 IU/cm^2,about 0.45 g for each wound),the wounds of rabbits in group AD were covered with gauze which was impregnated with 6 mL isoniazid injection and 0.15 g rifampicin powder-injection,the wounds of rabbits in group CT were covered with gauze which was impregnated with isoniazid injection and rifampiein powder-injection after being treated with recombinant bovine bFGF gel as before,the wounds of rabbits in group BC were covered with sterile gauze,with dressing change of once every two days until the wounds were completely healed.Immediately after surgery and on post surgery day (PSD)7,14,21,and 28,the wounds of rabbits in each group were observed with naked eyes and photos.On PSD 7,14,21,and 28,the wound healing rate was calculated and the complete healing time of wound was recorded.On PSD 7, 14,21,and 28,the tissue samples of wound edge were collected for histomorphological observation with hematoxylin and eosin staining and Masson staining.On PSD 21,the number of mierovessels was counted with immunohistochemical method.On PSD 7.,14,21,and 28,the content of hydroxyproline in wound edge was determined by en

关 键 词：分枝杆菌 结核 成纤维细胞生长因子 伤口愈合 模型 动物 

分 类 号：R641[医药卫生—外科学]