表皮生长因子膜对皮肤切口愈合促进及瘢痕抑制的作用

Effects of Promoting Healing and Scar Inhibition of Epidermal Growth Factor Film on Healing of Skin Incision Wounds

目的探讨表皮生长因子(epidermal growth factor,EGF)膜对皮肤切口愈合促进及瘢痕抑制的作用。方法选取36只SD大鼠随机将其分为治疗组和对照组各18只,麻醉后在脊柱两侧做皮肤切口至肌层,缝合伤口,对照组外敷空白膜,治疗组外敷自制EGF膜,每日更换,两组分别于伤后3、5、7、9、14、21 d各处死3只大鼠,制取标本,于肉眼下、Masson 3色染色及EGF免疫组织化学染色(伤后14、21 d未进行)后观察切口皮肤,并测定Ⅲ型前胶原(PCⅢ)含量。结果肉眼观察治疗组表皮层和真皮层愈合早于对照组。masson 3色染色结果显示对照组胶原纤维粗大,与创口呈垂直状态;治疗组成纤维细胞排列疏松、规则,伤口两侧新生胶原纤维量较少,胶原束纤细,排列相对疏松。EGF免疫组织化学染色结果显示对照组伤后3、5 d表皮上层由阴性转向强阳性,伤后7 d表皮上层与伤后5 d比较变化不明显,伤后9 d表皮上层呈阴性;治疗组伤后3、5、7、9 d表皮上层呈强阳或阳性。伤后3、5、7、9、14 d PCⅢ含量治疗组均高于对照组,差异有统计学意义(P<0.05)。结论应用外源性EGF能提高伤口中EGF水平,可促进伤口愈合,抑制瘢痕形成。

Objective To study the effect of promoting healing and scar inhibition of epidermal growth factor （ EGF） film on the dermal wound healing of rats. Methods 36 SD rats were randomly divided into treatment group and control group （ n=18 each group） . Under general anesthesia, two dermal incisions on both sides of the spine were as deep as the muscle layers. The incisions of two groups were applied with black film and epidermal growth factor （ EGF） film respectively. All films were changed daily to avoid infection. For each group three rats were killed on 3, 5, 7, 9, 14, 21 day after surgery and samples were obtained. The dermal incision was observed by visual and the histological study. In brief, incision changes were investigated by masson＇s trichrome staining and the expression of EGF in skin was detected with Streptavidin Peroxidase （ SP） immunohistochemical methods （not performed 14, 21 d after injury ）. The content of PCⅢ was also determined. Results The healing velocity of epidermal and dermis wounds were quicker in treatment group than that in control group. In terms of masson＇s trichrome staining：the new collagen fibers displayed smaller quantity, slimmer and looser arrangement in treatment group compared with that of control group. The epidermal of control group showed positive EGF staining on the 5th and 7th day, negative at the 3rd and 9th day. However, in treatment group, the upper part of the epidermal showed stronger positive EGF staining on the 3rd, 5th, 7th, 9th day. The content of PCⅢ in EGF film group was higher than that of the control group on all the days, except on the 21st day （P〈0. 05）. Conclusion The film made from EGF can enhance the content of EGF in wounds, improve wound healing process and repress scar. formation.