局部应用胰岛素对烫伤大鼠创面愈合的影响  

Effects of topical application of insulin on the wound healing in scalded rats

作　　者：刘琰[1] 章雄[1] 张志[1] 方培耀[1] 许伟石[1] 

机构地区：[1]上海第二医科大学瑞金医院烧伤科,200025

出　　处：《中华烧伤杂志》2004年第2期98-101,共4页Chinese Journal of Burns

摘　　要：目的　观察局部应用小剂量胰岛素对烫伤大鼠创面愈合的影响 ,探讨其可能的作用机制。　方法　制作深Ⅱ度烫伤大鼠模型。部分大鼠创面下浸润注射 0 .1、1.0U胰岛素 ,分别设为B、C组 ;以创面下浸润注射等渗盐水 (A组 )和腹部皮下注射 0 .1U胰岛素 (D组 )的烫伤大鼠作为对照。记录各组创面愈合时间 ,伤后 3d起隔日计算A、B、C组的创面愈合百分率。观察各组创面愈合后的组织形态学改变 ,采用流式细胞仪对各组创面表皮细胞进行细胞周期分析 ,并测定血糖浓度的变化。结果　A、B、C、D组创面愈合时间分别为 (2 4 .5 7± 5 .19)、(18.36± 4 .12 )、(2 1.4 6± 2 .97)、(2 4 .5 0±1.0 5 )d,B组较其他 3组明显缩短 (P <0.0 1)。伤后 5、9、11、13、15、17、19dB组创面愈合率均明显高于A组 ,且伤后 17d时明显高于C组 (P <0.0 5～ 0.0 1)。组织形态学观察可见A组表皮层薄 ,钉脚数量少 ,真皮层内多见纤维细胞 ;B、C组表皮层增厚 ,钉脚数量多 ,真皮层内多见成纤维细胞。B组伤后 4dS期细胞比例明显高于A组 (P <0.0 1);B组伤后 4、5dG2 M期细胞比例均明显高于A、C组(P <0.0 5～ 0.0 1)。烫伤后 2 4hA组血糖波动在 3.4 2～ 4 .6 2mmol/L;B组血糖变化规律与A组相似 ;C、D组注射后 1h血糖明显降低 (P <0.0 1),注射后 4h?Objective To investigate the effects of topical application of small dose of insulin on the wound healing of the scalded rats, so as to explore its mechanism. Methods The rats employed in the study were subjected to deep partial thickness burn and were divided into group A (with subcutaneous injection of isotonic saline into the rat wounds as control), B and C (with subcutaneous injection of 0.1 U and 1 U insulin in the rat wounds respectively) and D (with subcutaneous injection of 0.1 U insulin in the rat abdomen as control). The wound healing time and wound healing rate were assessed every other day after 3 postburn days (PBDs). The histological changes of the wounds after injection were examined, the changes in the cell cycle of epidermal cells in the wound were analyzed by flow-cytometry, and blood glucose concentration of each group was determined. Results The wound healing time in group B(18.36±4.12 d) was significantly shorter than that in other groups(A:24.57±5.19 d, C: 21.46±2.97 d , D: 24.50±1.05 d, P<0.01). The wound healing rate of the rats in group B in 5,9,11,13,15,17 and 19 PBD was obviously higher than that in group A, and was markedly higher than that in group C on 17 PBD(P<0.05-0.01). The epithelial layer was thinner with less epidermal nails but much more fibroblasts in epidermal layer in group A, while the epithelial layer was thicker with abundant epidermal nails in group B and C with many fibroblasts in the dermis. The amount of cells in S phase at 4 PBD in group B was dramatically higher than that in group A, and cells in G2M phase at 4-5 PBD in group B was also higher than that in group A and C(P<0.05-0.01). The blood level of glucose in group A and B fluctuated between 3.42 to 4.62 mmol/L at 24 PBH, while that in group C and D decreased obviously 1 hour after injection(P<0.01),but gradually returned to normal 4 hours after injection. Conclusion Local injection of small dose of insulin may accelerate burn wound healing due to its role in promoting the proliferation and division

关 键 词：胰岛素 烫伤 创面愈合 大鼠 流式细胞仪 细胞周期 血糖 

分 类 号：R644[医药卫生—外科学]