摘要
目的探讨重组人粒细胞-巨噬细胞集落刺激因子(rh GM-CSF)联合胰岛素对1型糖尿病大鼠深Ⅱ度烫伤创面组织中VEGF、HIF-1α及CD31表达的影响。方法选取50只健康雄性SD大鼠,按照随机数表法随机分为A组(10只)、B组(10只)、C组(10只)、D组(10只)、E组(10只),其中A组大鼠建立普通深Ⅱ度烫伤模型,并予以创面覆盖浸有5.0 m L生理盐水的纱布治疗;B组大鼠建立1型糖尿病深Ⅱ度烫伤模型,并予以创面覆盖浸有5.0 m L生理盐水的纱布治疗;C组大鼠建立1型糖尿病深Ⅱ度烫伤模型,并予以创面覆盖浸有5 U诺和灵30R+5.0 m L生理盐水的纱布治疗;D组大鼠建立1型糖尿病深Ⅱ度烫伤模型,并予以创面覆盖浸有25μg rhGM-CSF+5.0 m L生理盐水的纱布治疗;E组大鼠建立1型糖尿病深Ⅱ度烫伤模型,并予以创面覆盖浸有5 U诺和灵30R+25μg rhGM-CSF+5.0 m L生理盐水的纱布治疗。分别于烫伤后第3、7、11、15、21天观察各组大鼠的创面愈合情况,并采集创面组织,检测创面组织中VEGF、HIF-1α、CD31及HIF-1αmRNA的表达情况。结果烫伤后第3、7、11、15、21天各组大鼠创面均逐渐缩小或愈合,愈合率逐渐升高,其中尤以A组、E组大鼠创面组织中成纤维细胞及新生毛细血管生长速度最快,愈合最快,B组大鼠创面变化最慢,且烫伤后第11、15天,各组大鼠创面愈合率两两对比,除A组与E组及C组与D组对比,P>0.05,差异无统计学意义外,其余各组组间两两对比,P均<0.05,差异具有统计学意义。烫伤后第3、7、11、15、21天,各组大鼠创面组织中VEGF、HIF-1α、CD31的相对阳性表达量及HIF-1αmRNA的表达水平均呈先逐渐升高后降低的趋势,各组大鼠创面组织中VEGF、HIF-1α、CD31的相对阳性表达量及HIF-1αmRNA的表达水平两两对比,其中烫伤后第3、7、11、15、21天,E组大鼠创面组织中VEGF的相对阳性表达量分别与B组、C组及D组对比,P均<0.05,差异具有统计学意义;烫伤后第7、11、15、21天,E组大鼠创面组织中HIF-1αmRNA的表达水平分别与B组、C组及D组对比,P均<0.05,差异具有统计学意义。结论胰岛素联合rhGM-CSF治疗1型糖尿病大鼠深Ⅱ度烫伤创面,可显著提高大鼠创面组织中VEGF的表达水平、改善局部缺氧状态,从而加快新生毛细血管再生,有效减轻创面组织炎症反应程度,促进创面坏死组织清除,缩短创面愈合时间。
Objective To investigate the effect of rhGM-CSF combined with insulin on the expression of VEGF,HIF-1α and CD31 in the tissues of deep second degree scald wounds of rats with type 1 diabetes. Methods The included fifty healthy male SD rats were divided into five groups： Group A,B,C,D and E according to the random number table.Normal model of deep second degree scald wounds were made on rats of group A and then the wounds were covered with gauze soaked with 5. 0 ml normal saline; Models of type-1 diabetic deep second degree scald wounds were made on rats of group B,C,D and E,and then the wounds were covered respectively with gauze soaked with 5. 0 ml normal saline(group B）,gauze soaked with 5 u Novolin 30 R＋ 5. 0 ml normal saline(group C）,gauze soaked with 25 μg rhGM-CSF ＋ 5. 0 m L normal saline(group D） and gauze soaked with 5 u Novolin 30 R＋25 μg rhGM-CSF＋ 5. 0 ml normal saline(group E）. On respective day 3,7,11,15 and 21 after scalds,the wound healing condition of rats in each group was observed and the expression of VEGF,HIF-1α,CD31 and HIF-1α mRNA in wound tissues were tested. Results On day 3,7,11,15 and 21 after scalds,the wounds of the rats in each group all gradually decreased in size or healed with an increasing healing rate.The fibroblasts and newborn capillaries in group A and group E grew at the fastest speed and the wounds in the two groups healed in the shortest time while slowest wound change was observed in group B. The pairwise comparison of wound healing rate among the five groups on respective day 11 and 15 after scalds all showed statistically significant difference(P〈0. 05）,except the comparison of group A with group E,group C and group D which showed no statistically significant difference(P〈0. 05）. On day 3,7,11,15 and 21 after scalds,the relative positive expression quantity of VEGF,HIF-1α and CD31 and the expression level of HIF-1α mRNA in the rat wound tissues in each group all presented a trend of gradual increase followed by a decrease,and the pairwise comparison among the five groups showed that the relative positive expression quantity of VEGF in group E had statistically significant difference as compared to that in group B,C and D(all P〈0. 05）. On day 7,11,15 and 21 after scalds,the expression level of HIF-1α mRNA in group E had statistically significant difference as compared to that in group B,C and D,all P〈0. 05. Conclusion Insulin combined with rhGM-CSF in treating deep second degree scalds on rats with type 1 diabetes can markedly improve the expression of VEGF while decrease the expression of HIF-1α mRNA in wound tissues,thus speeding up the regeneration of newborn capillaries,effectively alleviating the inflammatory response of wound tissues and promoting the removal of wound necrotic tissues as well as shortening wound healing time.
作者
贺金秋
廖毅
李玲
王俊勇
He Jinqiu;Liao Yi;Li Ling;Wang Junyong(Department of Clinical Medicine （ Grade 2015 ） , Southwest Medical University, Luzhou City, Sichuan 646000, China;Burn and Plastic Surgery, Affiliated Hospital of Southwest Medical University, Luzhou City, Sichuan 646000, Chin;Surgery Department （Grade 2015）, Kunming Medical University, Kunming City, Yunnan 650500, Chin)
出处
《中国烧伤创疡杂志》
2018年第2期101-112,共12页
The Chinese Journal of Burns Wounds & Surface Ulcers
