MEBO联合微粒皮种植对糖尿病足创面组织中VEGF、EGF表达水平的影响

Influence of MEBO Combined with Micro-skin Grafting on the Expression of VEGF and EGF in Diabetic Foot Wounds

目的探讨湿润烧伤膏(MEBO)联合微粒皮种植对糖尿病足创面组织中血管内皮生长因子(VEGF)、表皮生长因子(EGF)表达水平的影响。方法给予2018年1月至2020年12月广州医科大学附属第五医院收治的38例Wagner 2~3级糖尿病足患者创面行MEBO联合微粒皮种植治疗,观察创面愈合情况,并对比治疗前与治疗第7、14天创面面积以及创面组织中VEGF、EGF含量。结果治疗2个月后,33例患者创面完全愈合、5例患者创面明显缩小。治疗过程中,38例患者创面组织中VEGF及EGF含量均呈逐渐升高趋势,其中各时间点创面组织中VEGF含量对比差异均具有统计学意义(q=10.310、23.280、12.970,P均<0.001);EGF含量除治疗前与治疗第7天对比,差异无统计学意义(q=1.797,P=0.945)外,其余各时间点对比,差异均具有统计学意义(q=12.040、10.240,P均<0.001)。Pearson相关系数分析结果显示,创面组织中VEGF、EGF含量与创面面积无明显相关性(r=0.181、0.205,P=0.833、0.094)。结论MEBO联合微粒皮种植促进糖尿病足创面愈合的机制可能与MEBO能够上调创面组织中VEGF、EGF的表达水平有关。

Objective To investigate the influence of MEBO combined with micro-skin grafting on the expression levels of vascular endothelial growth factor(VEGF)and epidermal growth factor(EGF)in diabetic foot wounds.Methods 38 patients with diabetic foot of Wagner gradeⅡ-Ⅲ,admitted into The Fifth Affiliated Hospital of Guangzhou Medical University between January 2018 and December 2020,were treated with MEBO combined with micro-skin grafting.The wound healing condition was observed,and the wound size and expression levels of VEGF and EGF in wound tissues were measured before treatment,and respectively on day 7 and 14 of treatment.Results After 2 months of treatment,the wounds of 33 patients were completely healed and the wound size significantly decreased in the other 5 patients.During the course of treatment,the levels of VEGF and EGF in wound tissues of the 38 patients presented a trend of gradual increase,and the VEGF levels in wound tissues were compared at different time points and the differences were all significant(q=10.310,23.280 and 12.970,all P<0.001).Except the level of EGF in wound tissues before treatment presenting no significant difference compared with that on day 7 of treatment(q=1.797,P=0.945),the comparisons of EGF levels at other different time points showed significantly differences(q=12.040 and 10.240,both P<0.001).Pearson correlation analysis showed that the expression levels of VEGF and EGF in wound tissues had no significant correlation with wound size(r=0.181 and 0.205,P=0.833 and 0.094).Conclusion The mechanism of the combined application of MEBO and micro-skin grafting in promoting wound healing of diabetic foot may be associated with the elevated expression of VEGF and EGF in wound tissues.