原位再生复原技术对糖尿病足溃疡创面血管化影响的相关研究

Correlation Study of the Effects of MEBT/MEBO on the Vascularization of Diabetic Foot Ulcers

目的探讨湿润烧伤膏(MEBO)联合创疡贴对糖尿病足溃疡创面血管形成的影响。方法将笔者2010年6月～201 1年6月收治的64例糖尿病足溃疡患者按随机数字表法分为两组,A组32例设为实验组,溃疡创面使用MEBO联合创疡贴换药治疗,每日2次;B组32例设为对照组,溃疡创面使用凡士林油纱布换药治疗,每日2次,两组患者均于创面处理当天,创面处理后7 d、12 d、21 d分别采取创面组织标本行免疫组织化学检测CD34含量,并用MVD计数,同时观察两组患者不同时间段创面肉芽组织的生长情况。结果两组患者创面处理当天及创面处理后7 d,创面肉芽组织生长情况及CD34含量无统计学差异(P>0.05);创面处理后12 d,A组创面肉芽组织生长面积(24.87%±0.24%)较B组(18.66%±0.45%)增大,CD34表达增强(8.34±0.48),与对照组(4.42±0.14)相比有统计学差异(P<0.05);创面处理后21 d,两组患者各项观察指标的统计学差异更为显著(P<0.01)。结论糖尿病足溃疡创面局部联合应用MEBO和创疡贴治疗,可促进创面血管形成,加速肉芽组织生长,其机理可能与激活创面内源性干细胞等因素有关。

Objective To discuss the effects of MEBO combined with MEBO Wound and Ulcer Dressing in the vascularization of DFUs. Methods A total of 64 patients with DFUs admitted from June 2010 to June 2011 were randomly divided into two groups. Group A was tile experimental group with 32 patients receiving the treatment of MEBO combined with MEBO Wound and Ulcer Dressing. Group B was the control group with 32 patients treated with Vaseline dressing twice a day. Immunohistochemical tests of the wound tissue samples was done on the 1st day, 7th day, 12th day and 21st day after wound management to measure the amount of CD34 counting by MVD, and meanwllile, the granulation tissue growth situation in both groups at different periods was also observed. Results There was no differences between the two groups in terms of granulation tissue growth and CD34 amount on tile first day and 7th day after wound management （ P 〉 0. 05 ）. On day 12, granulation tissue growth in group A （24. 87%±0. 24% ） was faster than growth in group B （ 18.66±0.45% ）and expression of CD34 of group A （8.34±0. 48） was higher than expression in group B （4.42±0. 14） which has statistical significance （ P 〈 0. 05 ）. Statistical significance of each index in both groups was more obvious on day 21 （ P 〈 0. 01 ）. Conclusion The combination of MEBO with MEBO Wound and Ulcer Dressing can promote vaseularization and granulation tissue growth of DFUs, of which the mechanism may relate to some factors including activating the endogenous stem cells on the wound and etc.