摘要
目的:观察重组人碱性成纤维细胞生长因子(recombinant human basic fibroblast growth factor,rh-bFGF)联合局部外用胰岛素治疗糖尿病深Ⅱ度烧伤的临床价值。方法:选取2017年5月-2018年5月笔者科室收治的80例糖尿病深Ⅱ度烧伤患者,按随机数表法分为观察组与对照组,每组40例。对照组采用rh-bFGF治疗,观察组采用rh-bFGF联合局部外用胰岛素治疗。比较两组创面愈合时间、治疗2周与3周的创面愈合率、治疗前、治疗2周时的创面缺氧诱导因子1α(hypoxia inducible factor-1α,HIF-1α)、血管内皮生长因子(vascular endothelial growth factor,VEGF)及微小RNA21表达,温哥华瘢痕量表(Vancouver Scar Scale,VSS)评价治疗后3个月与6个月的瘢痕增生程度,记录治疗期间不良反应。结果:观察组创面愈合时间(16.82±3.22)d,少于对照组的(21.91±4.01)d,治疗2周、3周的愈合率高于对照组,差异有统计学意义(P<0.05)。治疗2周后,两组创面VEGF、微小RNA21表达均较治疗前增强、HIF-1α表达减弱,差异有统计学意义(P<0.05)。观察组创面VEGF蛋白的阳性表达细胞数高于对照组,HIF-1α蛋白的阳性表达细胞数、微小RNA21的Ct值低于对照组,差异有统计学意义(P<0.05)。观察组治疗后3个月与6个月的VSS总评分分别为(3.94±0.63)分和(4.99±0.79)分,低于对照组(4.57±0.71)分和(5.70±0.82)分,差异有统计学意义(P<0.05)。两组治疗期间均未见严重感染情况。结论:重组人碱性成纤维细胞生长因子联合局部外用胰岛素治疗糖尿病深Ⅱ度烧伤可下调HIF-1α、上调VEGF,缩短创面愈合时间,减轻瘢痕形成,为安全可靠的治疗方案,值得推广。
Objective To observe the clinical value of rh-bFGF combined with topical insulin in the treatment of deep second degree burn of diabetes. Methods Total of 80 patients with deep second degree burn of diabetes mellitus admitted to our department from May 2017 to May 2018 were selected, and divided into the observation group and the control group according to the random number table method, with 40 cases in each group. The control group was treated with rh-bFGF, and the observation group was treated with rh-bFGF combined with topical application of insulin. The wound healing time, the wound healing rate of treating for 2 weeks and 3 weeks, the hypoxia-inducible factor-1α(HIF-1α), vascular endothelial growth factor (VEGF) and MicroRNA21 expression and treatment of the wound before treatment and 2 weeks after treatment, Vancouver Scar Scale (VSS) evaluated the degree of scar hyperplasia at 3 months and 6 months after treatment were compared between the two groups. The adverse reactions during treatment were recorded. Results The wound healing time of the observation group was (16.82±3.22)d, less than that of the control group (21.91±4.01)d, and the healing rate of 2 and 3 weeks after treatment in the observation group was higher than that of the control group, the differences were statistically significant(P<0.05). After 2 weeks of treatment, the expression of VEGF and MicroRNA21 of wound in two groups were stronger than those before treatment, while the expression of HIF-1α were weakened than before treatment(P<0.05). The number of positive cells expressing VEGF protein after treatment in the observation group was higher than that of the control group, while the number of positive cells of HIF-1α protein and the Ct value of MicroRNA21 after treatment were lower than those of the control group(P <0.05). The VSS total scores of the observation group at 3 months and 6 months after treatment [(3.94±0.63) points and (4.99±0.79) points] were lower than those of the control group [(4.57±0.71) points and (5.70±0.82) points,(P <0.05)]. No serious infection was found during treatment in two groups. Conclusion The recombinant human basic fibroblast growth factor combined with topical application of insulin in the treatment of deep second degree burn of diabetes can down-regulate HIF-1α, up-regulate VEGF, shorten wound healing time, and reduce scar formation. It is a safe and reliable treatment plan and worthy of promoting.
作者
张冀北
王峻岭
李慧
张丽
ZHANG Ji-bei;WANG Jun-ling;LI Hui;ZHANG Li(Department of Burn and Plastic Surgery,Cangzhou Central Hospital,Cangzhou 061000,Hebei,China)
出处
《中国美容医学》
CAS
2019年第2期32-35,共4页
Chinese Journal of Aesthetic Medicine
基金
沧州市重点研发计划指导项目(172302011)
关键词
重组人碱性成纤维细胞生长因子
胰岛素
糖尿病
深Ⅱ度
烧伤创面
局部外用
recombinant human basic fibroblast growth factor(rh-bfGf)
insulin
diabetes
deep second degree
burn wound
topical application
