富血小板血浆对难治性溃疡创面肉芽组织TGF-β_(1)/Smad4水平的影响及意义  

Plasma on the levels of TGF-β_(1)/Smad4 in granulation tissue of refractory ulcer wounds

作　　者：李忠兴 王嘉欣[1] 何金凤 张亚辉 付永峰 任娟 单楠 LI Zhongxing;WANG Jiaxin;HE Jinfeng;ZHANG Yahui;FU Yongfeng;REN Juan;SHAN Nan(Department of Plastic Surgery of The First Hospital of Qinhuangdao,Qinhuangdao 066000,China)

机构地区：[1]秦皇岛市第一医院整形外科,河北秦皇岛066000

出　　处：《中国实验诊断学》2025年第2期180-183,共4页Chinese Journal of Laboratory Diagnosis

摘　　要：目的观察富血小板血浆(PRP)对难治性溃疡的临床效果及其对创面肉芽组织TGF-β_(1)/Smad4表达的影响和意义。方法选取2019年1月1日至2021年12月31日在秦皇岛市第一医院住院的难治性皮肤溃疡患者116例,随机分为对照组和观察组,每组58例。于创面进入红色期时,对照组予以常规清创与敷料换药治疗,观察组在创面加用PRP伤口内注射与PRP凝胶覆盖。红色期第7d、第14d取两组创面肉芽组织,采用ELISA实验检测TGF-β_(1)和Smad4的水平;12W后评估疗效,并记录创面愈合时间和用药期间的不良反应发生情况。结果创面进入红色期时,两组患者肉芽组织的TGF-β_(1)和Smad4水平比较无显著性差异(P>0.05);红色期第7d,两组患者肉芽组织中TGF-β_(1)、Smad4水平较之前明显升高,且观察组高于对照组(P<0.05);红色期第14d,对照组的TGF-β_(1)、Smad4水平与红色期7d相比差异不大,观察组的TGF-β_(1)、Smad4水平仍有持续升高,且观察组高于对照组(P<0.05)。观察组临床有效率高于对照组,差异有统计学意义(P<0.05);红色期第14d的TGF-β_(1)、Smad4水平对临床疗效有较好的预测价值(P<0.05)。观察组溃疡面愈合时间短于对照组,差异有统计学意义(P<0.05);红色期第14d的TGF-β_(1)、Smad4水平与愈合时间呈现出高度负相关性(r=-0.774、-0.805,P<0.05)。结论PRP能够提高肉芽组织中TGF-β_(1)、Smad4分泌水平,促进组织修复。Objective To observe the clinical effect of platelet-rich plasma(PRP)on refractory ulcers,as well as its impact and significance on the expression of TGF-β_(1)/Smad4 in wound granulation tissue.Methods A total of 116 pa-tients with refractory skin ulcers hospitalized in the First Hospital of Qinhuangdao from January lst,2019 to December 31th,2021,were randomly divided into control group and observation group,with 58 cases in each group.When the wound entered the red stage,the control group was treated with routine debridement and dressing change,while the ob-servation group was additionally treated with intradermal injection of PRP into the wound and coverage with PRP gel.On the 7th and 14th days of the red stage,granulation tissue samples were taken from the wounds of the two groups.The levels of TGF-β_(1) and Smad4 were detected by ELISA.The curative effect was evaluated after 12 weeks,and the wound healing time and the occurrence of adverse reactions during the medication period were recorded.Results When the wound entered the red stage,there were no significant differences in the levels of TGF-β_(1) and Smad4 in the granula-tion tissue between two groups(P>0.05).On the 7th day of the red stage,the levels of TGF-β_(1) and Smad4 in the granulation tissue of the two groups of patients increased significantly compared with before,and those in the observa-tion group were higher than those in the control group(P<0.05).On the 14th day of the red stage,there was little difference in the levels of TGF-β_(1) and Smad4 in the control group compared with the 7th day of the red stage.The levels of TGF-β_(1) and Smad4 in the observation group continued to increase,and those in the observation group were higher than those in the control group(P<0.05).The clinical effective rate of the observation group was higher than the con-trol group,and the dfference was statistically significant(P<0.05).The levels of TGF-β_(1) and Smad4 on the 14th day of the red stage had a good predictive value for the clinical efficacy(P<0.05

关 键 词：富血小板血浆 难治性溃疡 转化生长因子(TGF-β_(1)) SMAD4 

分 类 号：R632.1[医药卫生—外科学]