糖尿病足部免疫表达和烧伤皮肤再生医疗技术干预治疗的影响  

Immune expression and moist exposed burn therapy/moist exposed burn ointment therapy in patients with diabetic foot

作　　者：吴标良[1] 唐乾利[2] 冯烈[1] 黄永秩[3] 王民登[4] 何晓微[5] 黄欣[5] 

机构地区：[1]暨南大学第一临床医学院,广东广州510632 [2]右江民族医学院附属医院胃肠外科 [3]右江民族医学院附属医院病理科 [4]右江民族医学院附属医院内分泌科 [5]广西中医药大学第一附属医院

出　　处：《上海医学》2014年第7期610-613,F0003,共5页Shanghai Medical Journal

基　　金：国家自然科学基金(81360547);广西自然科学基金重点项目(2013GXNSFDA019020)资助

摘　　要：目的观察2型糖尿病患者的糖尿病足部免疫表达状况,以及烧伤皮肤再生医疗技术湿润暴露疗法(MEBT)/湿润烧伤膏(MEBO)干预治疗对免疫表达的影响,探讨免疫在糖尿病足发病中的作用,以及MEBT/MEBO对糖尿病足部溃疡的修复机制。方法 60例2型糖尿病患者,按是否合并糖尿病足分为糖尿病足组(行MEBT/MEBO干预治疗)和非糖尿病足组,每组30例,分别取非糖尿病足组治疗前的三角肌组织和糖尿病足组干预治疗前后的创面肌肉组织,采用免疫组织化学法测定各组织中免疫球蛋白(Ig)A、IgG、IgM、C1q、C3c、C4c表达阳性率。结果干预治疗前,糖尿病足组IgA、IgG、IgM、C1q、C3c、C4c表达阳性率分别为16.7%(5/30)、0、13.3%(4/30)、0、3.3%(1/30)、0,均显著低于非糖尿病组[63.3%(19/30)、66.7%(20/30)、50.0%(15/30)、43.3%(13/15)、16.7%(5/30)、13.3%(4/30),P值分别<0.05、0.01];干预治疗后,糖尿病足组上述指标分别为73.3%(22/30)、73.3%(22/30)、66.7%(20/30)、3.3%(1/30)、26.7%(8/30)、16.7%(5/30),均显著高于同组治疗前(P值分别<0.05、0.01),与非糖尿病组间的差异均无统计学意义(P值均>0.05)。结论机体特别是局部组织免疫功能下降可能是糖尿病足的成因之一,MEBT/MEBO可能通过增强局部免疫表达而促进创面修复。Objective To investigate the immune expression in type 2 diabetes patients complicated with diabetic foot and the effect of moist exposed burn therapy/moist exposed burn ointment （MEBT/MEBO） therapy on immune expression, and to explore the role of immune in the development of diabetic foot and the repair mechanism of MEBT/MEBO therapy on diabetic foot ulcer. Methods Thirty type 2 diabetes patients with diabetic foot and thirty type 2 diabetes patients without diabetic foot were enrolled in the study. The deltoid of the patients without diabetic foot and wound muscle tissue of the patients with diabetic foot before and after treatment were collected. The expression of IgA, IgG, IgM, Clq, 03 and C4 were measured by immunohistochemistry. Diabetic feet were treated by MEBT/MEBO. Results The positive expression rates of IgA, IgG, IgM, Clq, 03 and 04 in the patients with diabetic foot before treatment were 16.7 % （5/30）, 0, 13.3 % （4/30）, 0, 3.3 % （1/30） and 0, respectively, which were significantly lower than those in the patients without diabetic foot （63.3% [19/30], 66.7% [20/30], 50.0% [15/30], 43.3% [13/15], 16.7% [5/30], and 13.3% [4/30], P〈0.05, 0.01）. The positive expression rates of IgA, IgG, IgM, Clq, 03 and 04 in the patients with diabetic foot after MEBT/MEBO therapy were 73.3% （22/30）, 73.3% （22/30）, 66.7% （20/30）, 3.3% （1/30）, 26.7% （8/30） and 16.7% （5/30）, respectively, which were significant higher than those before treatment （P〈0.05, 0.01 ）, while were not significantly different with those in the patients without diabetic foot （all P〉0.05）. Conclusion The decrease of immune function on local tissue may be the cause of diabetic foot. MEBT/MEBO may repair wound by enhancing the immune expression of injured tissue. （Shanghai Med J, 2014, 37： 610-613）

关 键 词：糖尿病足 免疫 皮肤再生医疗技术 

分 类 号：R587.2[医药卫生—内分泌]