水凝胶药物支架修复皮肤创面:临床应用可能性的挑战  

Hydrogel as drug scaffold in skin wound repair: challenges of clinical application possibilities

作　　者：甘丽莉 熊娜 刘燕飞 Gan Lili;Xiong Na;Liu Yanfei(Key Laboratory of Cell Engineering in Guizhou Province,Affiliated Hospital of Zunyi Medical University,Zunyi 563003,Guizhou Province,China)

机构地区：[1]遵义医科大学附属医院贵州省细胞工程重点实验室,贵州省遵义市563003

出　　处：《中国组织工程研究》2021年第22期3578-3583,共6页Chinese Journal of Tissue Engineering Research

基　　金：贵州省卫计委项目(Gzwjkj2017-1-036),项目负责人:刘燕飞;国家自然科学基金地区基金(31860265),项目负责人:刘燕飞。

摘　　要：背景:水凝胶凭借其三维网络状结构、优越的吸水保湿性和生物相容性在创面修复领域提供了独特的作用。目的:综述皮肤创面中水凝胶敷料作为支架材料在药物递送与缓释和清创止血方面的应用。方法:以“水凝胶,创面修复,糖尿病足,皮肤溃疡,烧伤,放射性皮炎,慢性创面,药物载体”或“hydrogels,wound healing,diabetic foot,skin ulcer,burns,radiodermatitis,chronic wounds,drug carriers”为检索词,交叉检索PubMed、CNKI、万方数据库中2000至2019年发表的文献。结果与结论:水凝胶具有类细胞外基质的三维结构,具有良好的可塑性、保水性和自愈合及持久缓释等特性,作为支架材料负载一种或多种药物应用于皮肤创面能增强各种药物抗感染、止血、清创方面的能力,能促进细胞黏附和生长因子的表达,诱导血管再生、胶原沉积、巨噬细胞极化和肉芽组织形成,最终促进汗腺和毛囊生成,加速上皮化,缩短愈合过程。然而,多功能水凝胶的开发及应用大多处于动物实验的基础研究阶段,尚缺乏大规模临床研究证明其疗效和安全性。BACKGROUND:Hydrogels play an important role in the field of wound repair because of its three-dimensional network structure,excellent moisture absorption and retention properties and biocompatibility.OBJECTIVE:To review the application of hydrogel dressings as scaffold materials in sustained drug release,debridement and hemostasis for skin traumas.METHODS: We took “hydrogels, wound healing, diabetic foot, skin ulcer, burns, radiodermatitis, chronic wounds, drug Carriers” as the key words in Chineseand English, respectively, to retrieve the related literature published from 2000 to 2019 in PubMed, CNKI, and Wanfang databases based on internet search.RESULTS AND CONCLUSION: Hydrogels have a three-dimensional structure similar to extracellular matrix and possess good plasticity, moisture retention,self-healing and long-lasting sustained release properties. As scaffold materials, hydrogels loaded with one or more drugs on skin wounds can enhance theanti-infection, hemostatic and debridement ability of drugs, promote cell adhesion and growth factor expression, induce angiogenesis, collagen deposition,macrophage polarization and granulation tissue formation, and finally, lead to the sweat glands and hair follicles formation, epithelialization acceleration,and shorten the healing process. However, the development and application of multi-functional hydrogels are mostly in the basic research stage of animalexperiments, and there is still a lack of large-scale clinical studies to prove their efficacy and safety.

关 键 词：材料 水凝胶 自组装材料 创面修复 糖尿病足 皮肤溃疡 慢性创面 药物缓释 综述 

分 类 号：R459.9[医药卫生—治疗学] R318.08[医药卫生—临床医学]