MEBT/MEBO对大鼠慢性难愈性皮肤溃疡创面肉芽组织EGF、EGFR表达的影响

Effects of MEBT/MEBO on the Expression of EGF and EGFR in the Wound Granulation Tissue of Rat Chronic Skin Ulcer

目的探讨烧伤湿性医疗技术(MEBT/MEBO)及配套产品湿润烧伤膏(MEBO)对大鼠慢性难愈性皮肤溃疡创面肉芽组织表皮生长因子(EGF)、表皮细胞生长因子受体(EGFR)表达的影响。方法 SPF级SD雄性大鼠45只,参照付小兵大鼠慢性性皮肤溃疡创面模型制作方法制作模型,成模后再采用随机数字表法随机分为模型组(15只)、MEBO组(15只)、贝复剂组(15只),造模后第2天开始用药,观察用药后各组创面愈合情况、肉芽组织生长情况,记录创面愈合时间;常规病理切片观察创面炎症、成纤维细胞数量、血管改变情况;透射电镜观察成纤维细胞及其线粒体形态结构;换药后第7、14天取创面组织,采用免疫组织化学法(SP法)观察MEBO对创面肉芽组织EGF、EGFR表达的影响。结果 MEBO组大鼠的创面愈合情况明显好于模型组与贝复济组;创面愈合时间明显短于模型组及贝复济组(P<0.05;P<0.01);病理学观察:MEBO组与贝复剂组及模型组比较,炎症反应轻、肉芽组织生长良好,纤维增生程度低;换药后第7、14天,MEBO组大鼠创面肉芽组织中EGF和EGFR蛋白表达阳性染色指数分别较模型组和贝复济组大鼠创面肉芽组织中EGF和EGFR蛋白表达阳性染色指数提高,差异有统计学意义(P<0.05)。结论 MEBO能增加慢性皮肤溃疡创面肉芽组织中EGF、EGFR的表达量,从而促进慢性皮肤溃疡愈合。

Objective To explore the effects of MEBT/ MEBO （i. e. Moist Exposed Burn Therapy and Moist Exposed Burn Ointment） on the expression of epidermal growth factor （EGF） and epidermal growth factor receptor （EGFR） in the wound granulation tissue of rat chronic skin ulcer. Methods Select 45 SPF SD male rats to make the rat chronic skin ulcerative wound models referring to the modeling method of FU Xiao-bin （Reference [1]）. After the formation of the model, randomly divide the 45 rats into three groups： model group （15 rats）, MEBO group （15 rats） and rb-bFGF （Recombinant Bovine Basic Fibroblast Growth Factor for External Use） group （15 rats）. From the second day after the model formation, begin to apply the medications on the wounds. The wound healing situation and the growth situation of granulation were observed, and the wound healing time was recorded. Take routine pathological section to observe the inflammatory situation, amount of fibroblasts, changes of blood vessels. Use transmission electron microscope to observe the morphology and structure of fibroblasts and their mitochondria. At the seventh and fourteenth days of dressing change, take the wound tissue and observe the effect of MEBO on the expression of EGF and EGFR in granulation tissue by using the Immunohistochemical method （SP method）. Results The healing situation and the healing time in MEBO group were both superior to that in the other two groups （P 〈 0. 05, P 〈 0. 01）. Pathological observation results： compared with the other two groups, MEBO group showed slighter inflammation, much better growth of granulation tissue and slighter fibroplasia. At the seventh and fourteenth days of dressing change, the positive staining index of EGF and EGFR in the granulation tissue of MEBO group was higher than that in the other two groups, and the difference between them was significant in statistics （P 〈 0. 05）. Conclusion MEBO can increase the expression of EGF and EGFR in granulation tissue of chronic skin ulcerative wound and thereby promote the healing of chronic skin ulcer.