摘要
目的:探讨自体脂肪源性干细胞(Adipose-derived stem cells,ADSCs)联合外膜敷贴对老年患者慢性创面生长因子的影响。方法:选取笔者医院2014年2月-2019年2月收治的老年慢性创面患者84例,根据随机数字表法分成对照组、观察组,各42例。对照组采用外膜敷贴(无菌生物护创膜)治疗,观察组采用自体ADSCs联合外膜敷贴治疗。在患者治疗2个月后复查时评估创面愈合效果。分别在治疗前、治疗2个月时取创面组织检测两组碱性成纤维细胞生长因子(bFGF)、表皮生长因子(EGF)、血管内皮细胞生长因子(VEGF)、血小板衍化生长因子(PDGF)水平,观察创面生长因子的变化。分析两组微血管计数(MVD)的变化,并记录两组创面愈合时间与并发症发生率。结果:观察组愈合率为92.86%显著高于对照组76.19%,差异有统计学意义(P<0.05)。两组治疗后bFGF、EGF、VEGF、PDGF阳性表达率均高于治疗前,且观察组较对照组显著增高(P<0.05)。观察组MVD计数为(38.53±2.45)个,较对照组的[(30.41±3.04)个]更高(P<0.05)。观察组愈合时间为(47.53±5.47)d少于对照组的(55.39±3.86)d,差异有统计学意义(P<0.05)。两组创面感染、破溃、皮肤坏死发生率比较差异无统计学意义(P>0.05)。结论:与单用外膜敷贴相比,老年慢性创面患者经自体ADSCs联合外膜敷贴治疗,能上调bFGF、EGF、VEGF、PDGF阳性表达率,提高MVD计数,缩短愈合时间,促进创面修复,疗效更好。
Objective To investigate the effect of autologous adipose-derived stem cells(ADSCs)combined with adventitia dressing on growth factor in elderly patients with chronic wounds.Methods 84 elderly patients with chronic wounds admitted to our hospital from February 2014 to February 2019 were selected and divided into the control group and the observation group according to random number table method,42 cases in each group.The control group was treated with adventitia application,while the observation group was treated with autologous ADSCs combined with adventitia application.The effect of wound healing was evaluated after 2 months of treatment.The levels of basic fibroblast growth factor(bFGF),epidermal growth factor(EGF),vascular endothelial growth factor(VEGF)and platelet-derived growth factor(PDGF)were measured before treatment and 2 months after treatment.The changes of microvessel(MVD)count were analyzed,and the healing time and complication rate were recorded.Results The healing rate of the observation group(92.86%)was significantly higher than that of the control group(76.19%),the difference was statistically significant(P<0.05).The positive rates of bFGF,EGF,VEGF and PDGF in the two groups after treatment were higher than those before treatment,and the positive rates in the observation group were significantly higher than those in the control group(P<0.05).The MVD count in the observation group was(38.53±2.45),higher than that in the control group(30.41±3.04,P<0.05).The mean healing time of the observation group was(47.53±5.47)d,which was significantly shorter than that of the control group[(55.39±3.86)d,P<0.05].There was no difference in the incidence of wound infection,ulceration and skin necrosis between the two groups(P>0.05).Conclusion Compared with the single application of external membrane,ADSCs combined with external membrane can increase the positive expression rate of bFGF,EGF,VEGF and PDGF,increase the MVD count,shorten the healing time,promote the wound repair and improve the curative effect.
作者
陆扬
LU Yang(Department of Burn and Plastic Surgery,Affiliated Hospital of Yangzhou University,Yangzhou 225000,Jiangsu,China)
出处
《中国美容医学》
CAS
2020年第6期63-66,共4页
Chinese Journal of Aesthetic Medicine
