负压创面疗法对Ⅲ/Ⅳ度烧伤患者外周血内皮祖细胞循环数量的影响研究

Effect of Negative Pressure Wound Therapy on the Number of Peripheral Blood Endothelial Progenitor Cells in Patients withⅢ/ⅣBurn

目的:探讨负压创面疗法(Negative pressure wound therapy,NPWT)对于Ⅲ/Ⅳ度烧伤患者外周血内皮祖细胞(Endothelial progenitor cells,EPCs)循环数量的影响。方法:本研究纳入了2017年3月-2019年3月在笔者医院烧伤科接受治疗的Ⅲ/Ⅳ度烧伤患者130例,将患者随机分为观察组(n=65)和对照组(n=65),均接受常规治疗,观察组在此基础上接受NPWT治疗,疗程为1周,比较两组患者治疗前后的外周血EPCs数量,并分析影响其变化的因素。结果:治疗后,观察组的外周血EPCs数量明显增加[(85.3±18.1)×10^6 vs(34.1±12.5)×10^6],差异有统计学意义(P<0.05)。而对照组无明显变化[(45.2±19.4)×10^6 vs(34.7±16.8)×10^6],差异无统计学意义(P>0.05)。此外,观察组的治疗后外周血的血管内皮生长因子(Vascular endothelial growth factor,VEGF)水平和肉芽组织内的VEGF和基质细胞衍生因子-1α(Stromal cell-derived factor-1α,SDF-1α)均显著增加(P<0.05),而对照组没有明显变化(P>0.05)。相关性分析结果显示,外周血EPCs数量与外周血和肉芽组织内的VEGF和SDF-1α水平显著相关(P<0.05)。结论:NPWT可以增加Ⅲ/Ⅳ度烧伤患者外周血EPCs数量,其机制可能与全身性和局部性的VEGF和SDF-1α水平上调相关。

Objective The present study was designed to investigate the effect of negative pressure wound therapy(NPWT)on the number of endothelial progenitor cells(EPCs)in patients withⅢ/Ⅳburns.Methods A total of 130 patients with gradeⅢ/Ⅳburns who were treated in the burn department of our hospital from March 2017 to March 2019 were enrolled.The patients were randomly divided into the observation group(n=65)and the control group(n=65).All patients received the routine treatment.In addition,the patients in the observation group received NPWT treatment in addition to the routine treatment.The course of treatment was one week.The number of peripheral blood EPCs before and after treatment in the two groups were compared,and the factors affecting the changes were analyzed.Results After treatment,the number of EPCs in the peripheral blood of the observation group were increased signifi cantly[(85.3±18.1)×10^6 vs(34.1±12.5)×10^6],the difference was statistically signifi cant(P<0.05).While the control group had no signifi cant change[(45.2±19.4)×10^6 vs(34.7±16.8)×10^6,P>0.05].In addition,the levels of vascular endothelial growth factor(VEGF)in peripheral blood and VEGF and stromal cellderived factor-1α(SDF-1α)in granulation tissue were significantly increased in the observation group(P<0.05),while the control group did not have signifi cant change(P>0.05).Correlation analysis showed that the number of peripheral blood EPCs was signifi cantly correlated with VEGF and SDF-1αlevels in peripheral blood and granulation tissue(P<0.05).Conclusion NPWT can increase the number of EPCs in peripheral blood of patients withⅢ/Ⅳburns.The mechanism may be related to the up-regulation of systemic and local VEGF and SDF-1αlevels.