摘要
目的探讨自体富血小板凝胶（autologous platelet-rich gel，APG）治疗糖尿病难治性皮肤溃疡可能的作用机制。方法分别于APG治疗前和治疗后3、6、9、15d取溃疡局部肉芽组织并观察溃疡面积，应用酶联免疫吸附法测定组织中PDGF-BB、VEGF、IGF-1、EGF和TGF-β，5种生长因子浓度。结果溃疡面积在APG治疗后第3d及第9～15d缩小明显（P〈0．05），5种生长因子浓度均在治疗后第3d开始升高，PDGF-BB浓度在第3d达高峰，较治疗前升高1．89倍（P〈0．05）；VEGF、IGF-1和TGF-β1在第9d达高峰，分别较治疗前升高2．10、1．95、1．67倍（P〈0．05）；EGF也在第9d达高峰，较治疗前升高1．75倍，但差异无统计学意义（P〉0．05）。结论APG治疗难治性溃疡的主要作用机制之一可能与APG中血小板激活后逐步释放多种生长因子导致溃疡组织局部生长因子浓度升高有关。
Objective To investigate the mechanism of autologous platelet-rieh gel （APG）in the treatment of refractory diabetic dermal ulcers. Methods After the treatment of refractory diabetic dermal ulcers with APG at 0, 3, 6, 9, 15 days, the protein levels of PDGF-BB, VEGF, IGF-1, EGF and TGF-β1 in the granulation tissue were detected by ELISA, while the dimensions of ulcer area were measured at the same time. Results The areas of ulcers were obviously reduced at the third and fifteen day after APG treatment（P〈0.05）. The concentrations of these 5 growth factors in the granulation tissue were began to increase after 3 days treatment, the peak of PDGF-BB emerged at the third day（P〈0. 05）, and the peaks of VEGF, IGF-1, TGF-β1 were found at the ninth day（P〈 0.05）. The concentration of VEGF increased 2.1-fold, IGF-1 increased 1.95-fold, EGF increased 1.75-fold, PDGF- BB increased 1.89-fold and TGF-β1 increased 1.67-fold. Conclusion The expression of multiple growth factors are increased in granulation tissue of refractory diabetic dermal ulcers after the treatment of APG,which might be one of the mechanism of APG to treat refractory diabetic dermal ulcer.
出处
《四川大学学报（医学版）》
CAS
CSCD
北大核心
2009年第2期292-294,共3页
Journal of Sichuan University(Medical Sciences)
基金
四川大学华西医院临床治疗新技术基金资助
