血竭负载于人工真皮支架修复猪Ⅲ度烧伤对创面愈合及瘢痕形成的影响  

Application of Sanguis draconis-coated artificial dermal stent in treatment of full-thickness burn wound of pigs

作　　者：孙东杰[1] 滕建英[2] 徐少骏 郭健[4] 

机构地区：[1]杭州师范大学附属医院,310015 [2]杭州师范大学临床医学院 [3]杭州瑞丽整形外科 [4]浙江省中医院

出　　处：《浙江医学》2014年第22期1833-1835,1840,I0001,共5页Zhejiang Medical Journal

基　　金：浙江省中医药科学研究基金(2011ZB124)

摘　　要：目的探讨负载不同浓度血竭对胶原-壳聚糖人工真皮支架修复猪Ⅲ度烧伤创面愈合及瘢痕形成、增生的影响。方法将负载4g/L和1g/L浓度血竭的真皮支架各移植于6头猪(共12头)Ⅲ度烧伤清创后创面(A、B组),这12头猪另一创面分别植入人工真皮支架及无支架的硅胶膜作为对照(C、D组)。观察植入支架后1、2、3、4周的创面修复情况,采用免疫组织化学方法检测不同时间4组创面转化生长因子TGF-β1和TGF-β3的表达。结果 A组创面修复优于B、C、D组。镜下可见A组创面各时间点的新生血管较其他3组多,差异有统计学意义(P<0.05)。A、B、C 3组的TGF-β1在2周时升高,3周时下降。D组前3周逐渐升高,4周时下降。前2周A、B、C组TGF-β1表达量高于D组,后2周则低于D组。A、B、C 3组TGF-β3表达持续升高3周,4周时回落,其中A组表达最高;D组在低水平上缓慢升高,各时间段均明显低于A、B、C 3组表达量。结论负载高浓度血竭能明显提高胶原-壳聚糖人工真皮支架修复Ⅲ度烧伤创面时的血管化速度,促进创面更快愈合的同时可有效抑制瘢痕增生。Objective To evaluate the efficacy of Chinese traditional medicine Sanguis draconis- coated col agen- chi-tosan artificial dermal stent in treatment of ful- thickness burn wound in pigs. Methods Ful thickness burn wounds were in-duced in 12 Bama miniature pigs. After debridement, col agen- chitosan artificial dermal stents coated with Sanguis draconis 4g/L （group A）, 1g/L （group B）, or artificial dermal stents without coating were implanted on wounds （group C）;the wounds without stents implantation served as controls （group D） . The wound repairing and pathological changes were observed 1, 2, 3 and 4 weeks after treatment;the TGF- β1 and TGF- β3 expressions in wounds were detected by immunohistochemical staining. Re-sults The wounds repairing and new micro- vessel growth in group A were better than those in other groups. Expression of TGF- β1 was increased in the wounds of groups A,B and C in the first 2 weeks,decreased at week 3;for group D it increased in the first 3 weeks and decreased at week 4. The expression of TGF- β1 of group A,B,C were higher in first 2 weeks and lower in last 2 weeks than that of group D. Expression of TGF- β3 was increased in groups A, B and C in the first 3 weeks and decreased at week 4 week;compared to group B and C TGF- β3 expression in group A was the highest. TGF- β3 expression in group D was lower than 3 groups at al time points. Conclusion Chinese traditional medicine Sanguis draconis- coated col agen- chitosan artificial dermal stent can promote angiogenesis in tissue, improve wound healing and inhibit the hyperplasia of scar in treatment of ful- thickness burn injury in pigs.

关 键 词：血竭 人工真皮支架 Ⅲ度烧伤 TGF-Β 瘢痕 

分 类 号：R644[医药卫生—外科学]