重组人酸性成纤维细胞生长因子联合夫西地酸乳膏局部应用对深Ⅱ度烧伤的影响

Effect of recombinant human acidic fibroblast growth factor combined with fusidic acid cream on patients with deep second degree burn

目的 观察重组人酸性成纤维细胞生长因子联合夫西地酸乳膏局部应用对深Ⅱ度烧伤患者的影响。方法 选取2019年6月至2020年5月河北中石油中心医院整形手外烧伤科治疗的120例深Ⅱ度烧伤患者为研究对象,采用随机数字表法对患者分组:对照组1、对照组2、观察组,每组40例患者。对照组1采用削痂术联合重组人酸性成纤维细胞生长因子治疗,对照组2采用削痂术联合夫西地酸乳膏治疗,观察组采用削痂术联合重组人酸性成纤维细胞生长因子和夫西地酸乳膏治疗,3组患者均连续治疗至创面愈合。治疗前、治疗第20天测量白细胞介素-2(interleukin-2, IL-2)、肿瘤坏死因子-α(tumor necrosis factor-α, TNF-α)、白细胞介素-10(Interleukin-10, IL-10)、白细胞介素-6(interleukin-6, IL-6)、血管内皮生长因子(vascular endothelial growth factor, VEGF)、表皮细胞生长因子(epidermal cell growth factor, EGF)、金属蛋白酶组织抑制因子1(tissue inhibitor of metalloproteinase 1, TIMP-1)、转化生长因子β1(transforming growth factor β1, TGF-β1)水平,观察患者创面愈合时间,采用温哥华瘢痕量表(vancouver scar scale, VSS)评价3组患者瘢痕增生程度,记录患者不良反应情况。结果 观察组TNF-α、IL-6水平低于对照组1和对照组2(P<0.05),观察组IL-2、IL-10水平高于对照组1和对照组2(P<0.05),观察组VEGF、EGF、TIMP-1、TGF-β1水平高于对照组1和对照组2(P<0.05),治疗第10、15、20天,3组创面愈合率升高(P<0.05),观察组创面愈合率高于对照组1和对照组2(P<0.05),观察组创面愈合平均时间低于对照组1和对照组2(P<0.05),观察组瘢痕血管分布、颜色、厚度和柔软度评分低于对照组1和对照组2(P<0.05),3组均无明显不良反应发生。结论 重组人酸性成纤维细胞生长因子联合夫西地酸乳膏局部应用治疗深Ⅱ度烧伤患者,可降低促炎因子TNF-α、IL-6水平,提升抑炎因子IL-2、IL-10水平,抑制炎症,提升VEGF、EGF、TIMP-1、TGF-β1水平,提升创面愈合率,降低瘢痕增生,安全性较高。

Objective To observe the effect of recombinant human acidic fibroblast growth factor combined with fusidic acid cream on patients with deep second-degree burn. Methods From June 2019 to May 2020,120 patients with deep second-degree burn were selected as the research subjects. All patients were randomly divided into control group 1,control group 2 and observation group,40cases in each group. In control group 1,patients were treated with scab ablation combined with recombinant human acidic fibroblast growth factor. In control group 2,patients were treated with scab ablation combined with fusidic acid cream. In the observation group,patients were treated with scab ablation,recombinant human acidic fibroblast growth factor and fusidic acid cream. All patients in 3 groups were treated continuously until wound healing. The interleukin-2(IL-2),tumor necrosis factor-α(TNF-α),interleukin-10(IL-10),interleukin-6(IL-6),vascular endothelial growth factor(VEGF),epidermal growth factor(EGF),tissue inhibitor of metalloproteinase-1(TIMP-1) and transforming growth factor-β1(TGF-β1) were measured before and 20 days after treatment. The wound healing time was observed,the degree of scar hyperplasia in 3 groups was evaluated by Vancouver Scar Scale(VSS) and the adverse reactions were recorded. Results The level of TNF-α and IL-6 in observation group was lower than that in control group 1 and 2(P<0.05),the level of IL-2 and IL-10 in observation group was higher than that in control group 1 and 2(P<0.05),and the level of VEGF,EGF,TIMP-1 and TGF-β1 in observation group was higher than that in control group 1 and 2(P<0.05). At 10,15 and 20 days of treatment,the wound healing rate in observation group was higher than that of control group 1 and 2(P<0.05),and the average wound healing time of observation group was shorter than that of control group 1 and 2(P<0.05). The scores of vascular distribution,color,thickness and softness of scar in observation group was lower than those of control group 1 and 2(P<0.05). No obvious adverse reactions occurred in 3 groups. Conclusion Application of recombinant human acidic fibroblast growth factor combined with fusidic acid cream in the treatment of deep second-degree burn can reduce the level of pro-inflammatory factors of TNF-α and IL-6,increase the level of anti-inflammatory factors of IL-2 and IL-10,inhibit inflammation,increase the level of VEGF,EGF,TIMP-1 and TGF-β1,improve wound healing rate and reduce scar hyperplasia. The safety was high.