高压氧联合重组人碱性成纤维细胞生长因子治疗皮肤难愈伤口疗效及机制研究  

Clinical Effect and Mechanism of Hyperbaric Oxygen Combined with Recombinant Human Basic Fibroblast Growth Factor for Treating Skin Refractory Wounds

作　　者：常和平[1] 李旭[1] 王伟[1] 王威[1] 叶凡[1] 

机构地区：[1]河北医科大学第三医院,河北石家庄050051

出　　处：《中国药业》2018年第2期46-49,共4页China Pharmaceuticals

基　　金：河北省2015年度医学科技研究重点课题计划[20150300]

摘　　要：目的研究高压氧联合重组人碱性成纤维细胞生长因子(rh-bFGF)治疗皮肤难愈伤口的临床疗效及可能机制。方法选择2015年1月至2017年1月接受住院治疗的创伤后皮肤损伤患者120例,根据随机数字表法分为常规治疗组、高压氧组、rh-bFGF组及联合组,各30例。常规治疗组给予反复清创、消肿换药或二次植皮与皮瓣移植等方式治疗,高压氧组在此基础上给予高压氧治疗,rh-bFGF组在常规治疗基础上给予rh-bFGF外用治疗,联合组在常规治疗基础上给予高压氧联合rh-bFGF治疗。结果联合组的显效率及总有效率均明显高于其他3组,差异均有统计学意义(P<0.05);组间比较,治疗3 d及7 d后,联合组的血管内皮生长因子(VEGF)、转化生长因子β1(TGF-β1)及结缔组织生长因子(CCN2/CTGF)水平均明显高于其他3组(P<0.05);组内比较,各组治疗3 d及7 d后的VEGF,TGF-β1,CCN2/CTGF水平均明显高于治疗前,且治疗7 d后的水平又明显高于治疗3 d后的水平(P<0.05)。组间比较,治疗3 d及7 d后,联合组的C反应蛋白(CRP)及肿瘤坏死因子-α(TNF-α)水平均明显低于其他3组(P<0.05);组内比较,各组治疗3 d及7 d后的CRP及TNF-α水平均明显低于治疗前,且治疗7 d后的水平又明显低于治疗3 d后的水平(P<0.05)。结论高压氧联合rh-bFGF治疗皮肤难愈伤口疗效较好,其机制可能在于二者联用可促血管生成和抑制炎性反应。Objective To study the clinical effect and possible mechanism of hyperbaric oxygen combined with recombinant human basic fibroblast growth factor（ rh-bFGF） in the treatment of skin refractory wounds. Methods Totally 120 patients with post-traumatic skin injury admitted to our hospital from January 2015 to January 2017 were selected and divided into the conventional treatment group,hyperbaric oxygen（ HBO） group,rh-bFGF group and combined group according to the random number table method,30 cases in each group. The conventional treatment group was given repeated debridement,detumescence and dressing change,or two times of skin grafting and skin flap transplantation,on this basis,the HBO group was given hyperbaric oxygen,the rh-bFGF group was given rh-bFGF,and the combined group was given hyperbaric oxygen combined with rh-bFGF. Results The effective rate and total effective rate of the combined group were significantly higher than those of the other 3 groups,and the differences were statistically significant（ P 0. 05）.After 3,7 d of treatment,the levels of vascular endothelial growth factor（ VEGF）,transforming growth factor β1（ TGF-β1） and connective tissue growth factor（ CCN2/CTGF） in the combined group were significantly higher than those in the other 3 groups（ P 0. 05）,the levels of VEGF,TGF-β1 and CCN2/CTGF in each group were significantly higher than those before treatment,and the levels after 7 d of treatment were significantly higher than those after 3 d of treatment（ P 0. 05）. After 3,7 d of treatment,the levels of C-reactive protein（ CRP） and tumor necrosis factor-α（ TNF-α） in the combined group were significantly lower than those in the other 3 groups（ P 0. 05）,the levels of CRP and TNF-α in each group were significantly lower than those before treatment,and the levels after 7 d of treatment were significantly lower than those after 3 d of treatment（ P 0. 05）. Conclusion Hyperbaric oxygen combined with rh-bFGF in the treatment of skin refractory wounds

关 键 词：高压氧 重组人碱性成纤维细胞生长因子 皮肤难愈伤口 疗效 机制 

分 类 号：R459.6[医药卫生—治疗学] R969.4[医药卫生—临床医学]