白芨胶载外源性重组人表皮生长因子促进伤口愈合机制

Mechanisms underlying the promotion of wound healing by bletilla carrying exogenous recombinant human epidermal growth factor

背景:如何促进难愈性创面愈合是所有外科医生研究的重点问题,重组人表皮生长因子可有效促进创面愈合,但其作为一种生物制剂,常温下极易被分解。目的:探讨中药白芨胶作为重组人表皮生长因子的载体促进兔背部伤口愈合的机制。方法:建立兔背部皮肤全层缺损创伤模型,用白芨胶和重组人表皮生长因子联合干预治疗,设为联合治疗组,并设白芨胶组、重组人表皮生长因子组及对照组作对照。结果与结论:(1)创面愈合情况:4组中联合治疗组创面愈合时间最短(P<0.05),创面愈合率最大(P<0.05)。(2)组织学变化:术后第3,10天,苏木精-伊红染色和Masson染色显示,联合治疗组可明显发现创面新生肉芽组织、毛细血管和胶原纤维形成。(3)血管内皮生长因子表达:术后第3,10天免疫组化染色显示,联合治疗组血管内皮生长因子表达在各组中最强(P<0.05)。(4)结果证实,白芨胶载外源性重组人表皮生长因子通过促进肉芽组织、新生毛细血管和胶原纤维的生成促进伤口愈合,效果显著,优于两者单独应用。

BACKGROUND： How to promote wound healing is always the research focus of the surgical physicians in the clinic. Recombinant human epidermal growth factor（rhE GF） can effectively promote wound healing. However, as a biological agent, it is easy to be decomposed under normal temperature. OBJECTIVE： To explore the mechanisms underlying the promotion of wound healing in the back of rabbits by bletilla carrying exogenous rh EGF. METHODS： Model rabbits with full-thickness skin defects in the back were treated with bletilla carrying exogenous rh EGF（combined treatment group）, bletilla, rh EGF, or saline（control group）. RESULTS AND CONCLUSION： The time of wound healing was the shortest（P〈0.05） and the wound healing rate was the highest（P〈0.05） in the combined treatment group. On postoperative days 3 and 10, newly formed granulation tissue, capillaries, and collagenous fibers showed by hematoxylin-eosin staining staining and Masson staining and the strongest immunoreactivity of vascular endothelial growth factor determined by immunohistochemical staining were found in the combined treatment group（P〈0.05）. These findings confirm that bletilla carrying exogenous rhE GF promotes wound healing by accelerating the forming of granulation tissue, new-born capillaries, and collagenous fibers, and the effects are superior to either of them alone.