负压创面疗法对慢性创面肉芽组织生长及白细胞介素-6的影响

Influence of negative pressure wound therapy on granulation tissue formation and interleukin-6 variation in chronic wound

目的研究负压创面疗法对慢性创面血管内皮细胞、增生期细胞及白细胞介素-6的影响。方法将40例慢性创面患者随机分为负压治疗组与常规治疗组。观察两组创面肉芽组织生长情况,并于治疗后1、4、7、14d取创面组织进行HE染色和免疫组化染色,观察血管内皮细胞(标志物采用兔抗人八因子抗原)和增生期细胞(标志物采用鼠抗人Ki-67抗原)数目,负压治疗组于上述时间点收集创面引流液,应用酶联免疫吸附试验法测定白细胞介素-6的含量。结果负压治疗组患者的治疗时间明显缩短,肉芽组织生长迅速,内皮细胞及增生期细胞数较常规治疗组显著增高(P<0.05),负压治疗组白细胞介素-6迅速下降。结论负压创面疗法能促进创面肉芽组织生长,加速内皮细胞生成,刺激细胞增生,降低创面白细胞介素-6含量。

[ Abstract] Objective To investigate the influence of negative pressure wound therapy （NPWT） on vascular endothelial ceils, proliferating cells and interleukin-6 variation in chronic wound. Methods Forty patients with chronic wound were divided into negative pressure wound therapy treatment group and conven- tional treatment group randomly. The granulation tissue formation was observed, and specimens were ob- tained from wound bed at 1,4, 7, 14 days after treatment. The specimens were pathologically studied with hematoxylin-eosin staining to assess the wound healing process of the two groups. Furthermore, immunohisto- chemistry was done to estimate the number of vascular endothelial ceils （ factor V~ related antigen being used as marker） and proliferating cells （mouse anti-Ki-67 nuclear antigen being used as marker）. Exudates of chronic wound were collected at 1,4, 7, 14 days after negative pressure wound therapy treatment, interleu- kin-6 contents were determined and comparisons were made between them based on enzyme linked Immu- nosorbnent assay. Results The wounds of patients in negative pressure wound therapy treatment group were cured rapidly. The granulation tissue formation was promoted in negative pressure wound therapy treatment group. The number of vascular endothelial cells and proliferating cells in negative pressure wound therapy treatment group was larger than that of conventional treatment group （ P 〈 0.05 ）. Interleukin-6 contents were decreased with time going after negative pressure wound therapy with significant variations between 1, 4, 7 days （ P 〈 0. 05 ）, and levels of interleukin-6 were got close to normal at 7, 14 days. Conclusion Compared with conventional treatment, negative pressure wound therapy could initiate granulation tissue formation more promptly, accelerate endothelial cell cytopoiesis, stimulate cell proliferation and decrease inter- leukin-6 contents.