壳聚糖创面修复膜凝胶对Ⅱ度烧伤患者血清TNF-α,IL-10及ICAM-1水平的影响  

Effect of Chitosan Wound Repair Membrane Gel on Serum Levels of TNF-α,IL-10 and ICAM-1 of Patients with Second Degree Burns

作　　者：赵景峰[1] 李涛[1] 李善友[1] 张新建[1] 陈泽群[1] 

机构地区：[1]解放军总医院第一附属医院烧伤整形科,北京100037

出　　处：《现代生物医学进展》2017年第24期4676-4679,4726,共5页Progress in Modern Biomedicine

基　　金：北京市自然科学基金项目(40K2028)

摘　　要：目的:探讨壳聚糖创面修复膜凝胶在Ⅱ度烧伤患者中的应用效果及对患者血清肿瘤坏死因子(TNF)-α、白介素(IL)-10、细胞间粘附因子(ICAM)-1水平的影响。方法:选择我院2015年6月~2016年11月收治的96例Ⅱ度烧伤患者并采取随机数字表将其分成两组,每组48例。观察组采用壳聚糖创面修复膜凝胶治疗,对照组常规给予凡士林油纱布包扎创面,对比两组创面愈合情况、血清TNF-α、IL-10及ICAM-1水平的变化及不良反应的发生情况。结果:治疗第7天,观察组浅Ⅱ度烧伤创面愈合率明显高于同时点对照组(P<0.01);治疗第15天、25天,观察组深Ⅱ度烧伤创面愈合率明显高于对照组同时点(P<0.05)。观察组浅Ⅱ度烧伤创面与深Ⅱ度烧伤创面愈合时间均显著短于对照组,SI评分均显著低于对照组(P<0.01)。两组浅Ⅱ度和深Ⅱ度烧伤患者治疗后血清TNF-α、IL-10、ICAM-1水平均较治疗前明显下降,观察组下降更明显(P<0.05)。观察组创面感染发生率显著低于对照组(P<0.05)。结论:壳聚糖创面修复膜凝胶用于Ⅱ度烧伤患者中能加快创面愈合,预防创面感染,减轻机体炎症反应,安全性高。Objective：To explore the effect of chitosan hydrogel on the serum levels of tumor necrosis factor （TNF-α）,interleukin （IL-10） and intercellular adhesion molecule （ICAM-1） of patients with burns.Methods：96 cases with second degree burns who were treated in our hospital from June 2015 to November 2016 were selected and randomly divided into two groups,with 48 cases in each group.The patients in the observation group were treated with chitosan hydrogel,while the patients in the control group were treated with conventional vaseline gauze wound.Then the wound healing,the serum levels of tumor necrosis factor （TNF-α）,interleukin （IL-10） and intercellular adhesion molecule （ICAM-1） and the incidence of adverse reactions were observed and compared between the two groups before and after the treatment.Results：The healing rate of superficial burns at the 7th day in the observation group was significantly higher than that of the control group （P＜0.01）.The healing rate of deep burns at the 15th day and 25th day were significantly higher than those of the control group （P＜0.05）.The healing time of the superficial burns and deep bums in the observation group were significantly shorter than those of the control group,and the SI score was significantly lower （P＜0.01）.After treatment,the serum levels of TNF-α,IL-10 and ICAM-1 of patients with superficial burns significantly decreased in the two groups,and the observation group was lower than that of the control group （P＜0.05）.The serum levels of TNF-α,IL-10 and ICAM-1 of patients with deep burns were significantly lower than before,and the observation group was lower than that of the control group （P＜0.01）.The incidence of wound infection in the observation group was lower than that of the control group （P＜0.05）.Conclusion：Chitosan wound repair membrane gel could accelerate the wound healing,prevent the wound infection,and reduce the inflammation with high safety.

关 键 词：壳聚糖 烧伤 创面愈合 肿瘤坏死因子-α 白介素-10 细胞间粘附因子-1 

分 类 号：R644[医药卫生—外科学]