[封闭负压引流对糖尿病足创面转化生长因子β及其受体表达的影响]
[Effect of vacuum sealing drainage on expressions of transforming growth factor β and its receptor in diabetic foot wound].
作者信息
Hu Chenghao, Li Dongyu, Pang Zongchao, Li Huibin, Dongye Yuhui, Wu Jiani
机构信息
College of Clinical Medicine, Weifang Medical University, Weifang Shandong, 261000, P.R.China;The Second Department of Burns and Plastic Surgery, People's Hospital of Linyi, Linyi Shandong, 276000, P.R.China.
College of Agricultural and Life Science, University of Wisconsin-Madison, Madison Wisconsin, 53706, USA.
出版信息
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2018 Aug 15;32(8):1061-1065. doi: 10.7507/1002-1892.201802024.
OBJECTIVE
To investigate the changes of transforming growth factor β (TGF- β ) and type Ⅱ of TGF-β-receptor (TβRⅡ) expressions in wound tissue after the treatment of diabetic foot with vaccum sealing drainage (VSD), and to analyze the mechanism of accelerating wound healing.
METHODS
Between May 2012 and May 2016, 80 patients with diabetic foot were randomly divided into 2 groups, 40 cases in each group. After the same basic treatment, the wounds of VSD group and control group were treated with VSD and external dressing, respectively. There was no significant difference in gender, age, disease duration, body mass, foot ulcer area, and Wagner grade between 2 groups ( >0.05). The time of foundation preparation and hospitalization stay of 2 groups were recorded. The wound tissue was collected before treatment and at 7 days after treatment, and the positive indexes of TGF-β and TβRⅡexpressions were measured by immunohistochemical staining.
RESULTS
Before skin grafting, the patients in VSD group were treated with VSD for 1 to 3 times (mean, 2 times), and the patients in control group were treated with dressing change for 1 to 6 times (mean, 4 times). The time of foundation preparation and hospitalization stay in VSD group were significantly shorter than those in control group ( =-13.546, =0.036; =-12.831, =0.041). The skin grafts of both groups survived smoothly and the wound healed well. Before treatment, immunohistochemical staining results showed that the positive indexes of TGF-β and TβRⅡ expressions in VSD group were 5.3±2.4 and 14.0±2.6, while those in control group were 4.4±2.3 and 14.7±3.1, respectively. There was no significant difference between 2 groups ( =1.137, =0.263; =1.231, =0.409). At 7 days after treatment, the positive indexes of TGF-β and TβRⅡ expressions in VSD group were 34.3±2.9 and 41.7±3.7, respectively, and those in control group were 5.8±2.0 and 18.1±2.5. There were significant differences between 2 groups ( =-35.615, =0.003; =23.725, =0.002).
CONCLUSION
VSD can increase the expressions of TGF-β and TβRⅡ in diabetic ulcer tissue, promote granulation tissue growth, and accelerate wound healing.
目的
探讨负压封闭引流（VSD）治疗糖尿病足后创面组织中转化生长因子β（TGF-β）及转化生长因子βⅡ型受体（TβRⅡ）表达的变化，分析其促进创面愈合的机制。
方法
选取2012年5月至2016年5月间80例糖尿病足患者，随机分为2组，每组40例。两组均给予相同的基础治疗，VSD组创面采用VSD治疗，对照组创面采用传统换药。两组患者性别、年龄、病程、体质量、足部溃疡面积及Wagner分级比较，差异均无统计学意义（P>0.05）。记录两组患者的创面准备时间及住院时间。分别于治疗前及治疗后7 d取创面组织，采用免疫组织化学染色法检测TGF-β及TβRⅡ表达的阳性指数。
结果
植皮前，VSD组患者行VSD治疗1～3次（平均2次），对照组患者行换药治疗1～6次（平均4次）。VSD组创面准备时间及住院时间均明显短于对照组（t=-13.546，P=0.036；t=-12.831，P=0.041）。两组患者植皮均顺利成活，创面愈合良好。治疗前，免疫组织化学染色结果显示，VSD组TGF-β及TβRⅡ表达的阳性指数分别为5.3±2.4、14.0±2.6，对照组分别为4.4±2.3、14.7±3.1，两组比较差异均无统计学意义（t=1.137，P=0.263；t=1.231，P=0.409）。治疗后7 d，VSD组TGF-β及TβRⅡ表达的阳性指数分别为34.3±2.9、41.7±3.7，对照组分别为5.8±2.0、18.1±2.5，两组比较差异均有统计学意义（t=-35.615，P=0.003；t=23.725，P=0.002）。
结论
VSD可增加糖尿病溃疡组织中TGF-β及TβRⅡ的表达，促进肉芽组织生长，加速创面愈合。
Zotero 插件