眼镜蛇伤溃疡创面炎症细胞趋化及血管内皮因子表达的临床研究

Study of Inflammatory Cell Chemotaxis and VEGF Secretion in Ulcerated Wound By Cobrasnake Bite

目的探讨眼镜蛇咬伤后局部软组织炎症反应及血管内皮因子(VEGF)分泌的变化。方法将20例因眼镜蛇咬伤致局部组织溃疡的患者分为治疗组10例、对照组10例。两组均常规清创换药。治疗组常规创面清创后,以复方四黄液外敷伤口肿胀处;对照组以50%硫酸镁外敷伤口肿胀处。溃疡发生后第1天、第7天分别在创缘处切取大小2 mm×2 mm大小的组织,检测VEGF,巨噬细胞、中性多核白细胞(PMN)、淋巴细胞。7 d后两组患者按照创面情况选用不同手术方式修复创面。结果两组患者组织中VEGF、巨噬细胞、PMN、淋巴细胞检测结果表明,溃疡发生后第1天两组差异无统计学意义(P>0.05),溃疡发生后第7天,与对照组比较,治疗组创面巨噬细胞计数,VEGF显著增加,差异有统计学意义(P<0.05),而其PMN及淋巴细胞计数则明显降低,差异有统计学意义(P<0.01)。治疗组创面修复愈合平均时间短于对照组。结论中西医结合治疗眼镜蛇咬伤致局部组织溃疡,可通过调节巨噬细胞、淋巴细胞趋化以及升高血管内皮生长因子水平而降低炎症反应,改善局部血流,促进伤口愈合。

Objective To observe the effects of Fufang Sihuangye( FFSHY) on inflammatory cell chemotaxis and VEGF secretion in ulcerated wound by cobrasnake bite. Methods Twenty patients bitten by cobrasnake with ulcerated wound were divided into conventional group( n = 10) and observation group( n =10). The external application of FFSHY was used in the observation group and 50% magnesium sulphate was used in the control group. The tissue of wound edge were taken to detect the content of VEGF,Macrophages,PMN,lymphocytes on the 1st and 7th day. According to the condition of wounds,patients were chosen for different surgical methods 7 days later. Results There was no significant difference about the content of VEGF,Macrophages,PMN,lymphocytes( P > 0. 05) on the 1st day. After 7 days,the content of VEGF,Macrophages in observation group had a higher expression level than conventional group. On the other hand,the content of PMN,lymphocytes was lower. The average time of wound healing in observation group was shorter than conventional group. Conclusion The method of combination traditional Chinese and western medicine can reduce the inflammation,increase local blood flow,and promote the healing process.