表皮生长因子在糖尿病足溃疡创面愈合过程中的作用观察及其机制探讨

Role and theory of epithelial growth factor in the treatment of diabetic foot ulcers

关键词:  表皮生长因子  糖尿病足  创面愈合

Key words:  [Key words] Epithelial growth factor (EGF)  diabetic foot  wound healing

摘要:

[摘要]　目的　探讨表皮生长因子（EGF）对糖尿病足溃疡创面愈合的治疗效果及其作用机制。　方法　将入选的32只糖尿病足新西兰兔随机分为2组：表皮生长因子组（A组）和对照组(B组)，每组16只。将2组实验用兔大腿部切除10 mm×7 mm矩形区域全层皮肤，一组局部创口连续涂抹表皮生长因子（EGF），用量从始至终为1 mL,1次/d（A组）；另一组不施加干预（B组）。15 d后沿超出创面外缘2 mm处取下创面新生肉芽组织并作Masson染色、HE染色、电镜观察及内源性EGFmRNA检测。　结果　 〖HTK〗（1）光镜下A组可见大量成纤维细胞聚集成群，轮廓较清晰，细胞外基质丰富，胶原纤维束排列密集而有序，可见大量血管生成，组织分层愈合良好；B组可见创面愈合缓慢，胶原纤维稀疏，组织结构不明显。电镜下A组可见成纤维细胞体积大、形态完好、胞质内细胞器丰富，细胞周围可见大量胶原纤维排列整齐有序;B组成纤维细胞形态不规则，细胞内容物少，周围胶原纤维稀疏，排列混乱。（2）内源性EGFmRNA检测发现：A组EGFmRNA的灰度相对值为109.31±5.17；B组EGFmRNA的灰度相对值为61.59±4.61，两组比较，差异有显著性意义(P<0.01)。　结论　表皮生长因子能够促进糖尿病足溃疡创面的愈合，可能机制为外源性的EGF上调了局部组织中EGFmRNA的表达。

Abstract:

[Abstract] Objective To investing the mechanism of Epithelial growth factor (EGF) in promoting diabetic foot ulcers(DFU) to heal. 　Methods Selected 32 New Zealand rabbits of diabetic foot were randomly assigned to two groups, EGF group (group A) and control group (group B), 16 for each group. The all layers skin of two groups animal were removed in rectangle area of 10 mm×7 mm. After 15 days,we taked out new flesh organize though 2 mm margin of diabetic foot ulcers.Tissue sections of each DFU were stained by masson and trichrome HE after 15 days and observed under electron microscope. EGF mRNA were detected with RT-PCR. 　Results Observing the group A with light microscope, a large number of fibroblasts gathered in groups,edge sharpness,rich in the extracellular matrix,collagen fiber bundlingwith dense and orderly,with a large number of angiogenesis,organization healing welll in every layers.Group B,there were the wound healing slowly,fibroblasts sparsely,Organizational structure not obviouly.Observing the group A with electron microscope,the fibroblasts of group A were bigger and in good shape, organelle being rich cytoplasm. A great amount of collagen were very regular surrounded the cells. The fibroblasts of group B were in irregular form，organelle being poor. A great amount of colla gen were very sparse surrounded the cells. EGF mRNA detection:EGFmRNA relative gray was 109.31±5.17 in group A,was 61.59±4.61 in group B(P<0.01). 　Conclusion EGF can promote the wound healing of DFU. Moreover, external EGF might stimulate the expression of internal EGFmRNA.