不同方法联合放疗治疗薄型瘢痕疙瘩的疗效及对MMPs、HIF-1α、TGF-β1的影响  

Effect of different methods combined with radiotherapy on thin keloid and influence on MMPs,HIF-1αand TGF-β1

作　　者：陈向军 于丽[3] 姚尧 吴迪[2] 王星 李志军 CHEN Xiang-jun;YU Li;YAO Yao(Graduate School of Inner Mongolia Medical University,Hohhot,Inner Mongolia 010110,China;Department of Plastic Surgery,4 Department of Dermatology,Affiliated Cancer Hospital of Inner Mongolia Medical University(Inner Mongolia Autonomous Region Cancer Hospital),Hohhot,Inner Mongolia 010020,China;Department of Critical Care Medicine,The 969th Hospital of the Joint Logistics Support Force of the People's Liberation Army of China,Hohhot,Inner Mongolia 011011,China;不详)

机构地区：[1]内蒙古医科大学研究生院,内蒙古呼和浩特010110 [2]内蒙古医科大学附属肿瘤医院(内蒙古自治区肿瘤医院)整形外科,内蒙古呼和浩特010020 [3]中国人民解放军联勤保障部队第九六九医院重症医学科,内蒙古呼和浩特011011 [4]内蒙古医科大学附属肿瘤医院(内蒙古自治区肿瘤医院)皮肤性病科,内蒙古呼和浩特010020 [5]内蒙古医科大学基础医学院人体解剖学教研室,内蒙古呼和浩特010110

出　　处：《临床和实验医学杂志》2024年第9期995-999,共5页Journal of Clinical and Experimental Medicine

基　　金：内蒙古自治区自然科学基金项目(编号:2020LH08021)。

摘　　要：目的探讨不同方法联合放疗治疗薄型瘢痕疙瘩的疗效及对基质金属蛋白酶(MMPs)、缺氧诱导因子-1α(HIF-1α)及转化生长因子-β1(TGF-β1)的影响。方法回顾性选取2020年10月至2022年9月内蒙古医科大学附属肿瘤医院(内蒙古自治区肿瘤医院)整形外科收治的胸腹部瘢痕疙瘩患者62例(瘢痕疙瘩数94个),依据治疗方法不同分为激光联合放疗(LCR)组(30例,瘢痕疙瘩数47个)、手术联合放疗(SCR)组(32例,瘢痕疙瘩数47个)。LCR组行CO 2点阵LCR,SCR组行SCR。观察两组治疗12个月后临床疗效、复发情况。比较两组治疗前、治疗12个月后的患者与观察者瘢痕评估量表(POSAS)评分、温哥华瘢痕量表(VSS)评分、瘢痕组织基质金属蛋白酶(MMP)-2、MMP-9、HIF-1α、TGF-β1等细胞因子水平的变化。结果LCR组总有效率(93.62%)大于SCR组(76.60%),复发率(4.26%)小于SCR组(19.15%),差异均有统计学意义(P<0.05)。治疗12个月后,LCR组POSAS、VSS评分分别为(23.96±2.64)、(5.28±0.54)分,均低于SCR组[(33.96±3.59)、(6.55±0.68)分],差异均有统计学意义(P<0.05)。LCR组瘢痕组织MMP-2、MMP-9及HIF-1α、TGF-β1表达量分别为111.65±13.55、106.76±12.68、1.24±0.14、1.10±0.12,均低于SCR组(127.96±14.71、121.08±14.33、1.55±0.17、1.22±0.13),差异均有统计学意义(P<0.05)。两组不良反应发生率比较(38.30%vs.46.81%),差异无统计学意义(P>0.05)。结论LCR和SCR均可改善薄型瘢痕疙瘩症状,抑制瘢痕疙瘩复发,但LCR的治愈率更高,复发率更低,对瘢痕组织MMPs及HIF-1α、TGF-β1表达抑制作用更强,且安全性较高,值得临床推荐。Objective To study the effects of different methods combined with radiotherapy on thin keloid and the effects on matrix metalloproteinases(MMPs),hypoxia inducible factor-1α(HIF-1α),and transforming growth factor-1β(TGF-β1).Methods A total of 62 patients with thoracic and abdominal keloids(94 keloids)admitted to the Department of Plastic Surgery,Affiliated Cancer Hospital of Inner Mongolia Medical University(Inner Mongolia Autonomous Region Cancer Hospital)from October 2020 to September 2022 were selected and divided into laser combined with radiotherapy(LCR)group(30 cases,47 keloids)and surgery combined with radiotherapy(SCR)group(30 cases,47 keloids)according to different treatment methods.The LCR group received CO 2 lattice LCR,and the SCR group received SCR.The clinical efficacy and recurrence rate were observed after 12 months of treatment in the two groups.Changes of patient and observer scar assessment scale(POSAS)score,Vancouver scar scale(VSS)score,cytokines such as matrix metalloproteinase(MMP)-2 and MMP-9,HIF-1αand TGF-β1 in scar tissue before and after 12 months of treatment in two groups.Results The total effective rate of LCR group was 93.62%,which was higher than that of SCR group(76.60%),and the recurrence rate was 4.26%,which was lower than that of SCR group(19.15%),the differences were statistically significant(P<0.05).After 12 months of treatment,POSAS and VSS scores in LCR group were(23.96±2.64)and(5.28±0.54)points,which were lower than those in SCR group[(33.96±3.59)and(6.55±0.68)points],the differences were statistically significant(P<0.05).The levels of MMP-2,MMP-9,HIF-1αand TGF-β1 expression in scar tissue of LCR group were 111.65±13.55,106.76±12.68,1.24±0.14,1.10±0.12,which were lower than those in SCR group(127.96±14.71,121.08±14.33,1.55±0.17,1.22±0.13),the differences were statistically significant(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(38.30%vs.46.81%)(P>0.05).Conclusion LCR and SCR both

关 键 词：瘢痕疙瘩 基质金属蛋白酶类 缺氧诱导因子-1 Α亚基 转化生长因子-β1 手术联合放疗 激光联合放疗 

分 类 号：R622[医药卫生—整形外科]