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目的研究重组人粒细胞-巨噬细胞集落刺激因子(rh GM-CSF)和纳米银敷料联合外用对深Ⅱ度烫伤创面愈合过程中血管化的影响。方法用Wistar大鼠建立深Ⅱ度烫伤模型,随机均分为模型组、纳米银组、rh GM-CSF组、rh GM-CSF+纳米银组,各组大鼠按相应方法处理创面后,于第1、4、7、10、14、21天观察创面的病理学改变;按照酶联免疫吸附法测定血清中VEGF的水平;采用RT-PCR法检测创面愈合过程中HIF-1αmRNA的变化。结果各组大鼠均在第10天出现明显的血管化;模型组大鼠血清的VEGF水平持续上升,纳米银组、rh GM-CSF组、rh GM-CSF+纳米银组的于第14天达峰值,第4、7、10、14、21天各组间差异有统计学意义(P<0.05);各组大鼠创面中HIF-1αmRNA的相对表达量逐渐增大,模型组于第14天达峰值,其余3组均于10 d时达峰值,随后逐渐下降,rh GM-CSF+纳米银组的下降幅度最大,第1、4、7、10、14、21天各组间的差异均有统计学意义(P<0.05)。结论 rh GM-CSF和纳米银联合外用可加速深Ⅱ度烫伤创面愈合过程中血管化的形成,并且血管化程度优于rh GM-CSF或纳米银单独使用。
Objective To investigate the effect of rh GM-CSF combined with nanosilver dressing on the vascularization of deep second degree scald wound healing. Methods The deep second degree scald model was established in Wistar rats and randomly divided into model group, nano-silver group, rh GM-CSF group and rhGM-CSF + nano silver group. The rats in each group were treated with the corresponding method, The pathological changes of the wounds were observed on days 1,4,7,10,14,21. The level of VEGF in serum was determined by enzyme-linked immunosorbent assay. The changes of HIF-1αmRNA in wound healing were detected by RT-PCR. Results The vascularization of rats in each group was obvious on the 10th day. The level of VEGF in the serum of the model group continued to increase. On the 14th day, the level of VEGF in the nano-silver group, rh GM-CSF group and rh GM-CSF + (P <0.05). On the 4th, 7th, 10th, 14th and 21st day, the relative expression of HIF-1αmRNA in the wounds of rats in each group gradually increased. On the 14th day The peak value of the other three groups reached the peak on the 10th day, then gradually decreased, the largest decline of rh GM-CSF + nano-silver group, the first, 4th, 7th, 10th, 14th, 21st day differences among the groups Statistical significance (P <0.05). Conclusion rh GM-CSF combined with nano-silver can accelerate the formation of vascularization during deep second degree scald wound healing, and the degree of vascularization is better than rh GM-CSF or nano-silver alone.