外用GM-CSF凝胶提高生物复合膜覆盖微粒皮移植质量的研究

发布时间：2019-02-16 10:07

【摘要】：目的：评估微粒皮移植时外用重组人粒细胞巨噬细胞集落刺激因子(rhGM-CSF)凝胶是否能够通过促进创面血管化和上皮化,从而提高生物复合膜覆盖微粒皮移植的存活率,进一步为生物复合膜、rhGM-CSF的研究及临床应用探寻一条新的路径。方法：将30只实验兔随机分为5组,每组6只,在每只背部两侧各切掉约4cm×4cm大小的全厚皮肤,左右部位随机分为实验组和对照组。将取下皮肤的1/10剪成微粒皮回植于创面,实验组覆盖涂抹有rhGM-CSF的壳聚糖/葡甘聚糖生物复合膜；对照组部位只覆盖壳聚糖/葡甘聚糖生物复合膜,进行单纯缝合留线打包固定。5组分别于术后的第1、2、3、4、5周五个时间点,进行拆包对照观察创面愈合状况,于相对称创面位置取组织进行HE的染色、CD31和PCNA的免疫组化检测,从而对创面的修复状况进行评估。结果：术后第1周及第2周实验组创面愈合率高于对照组(p0.01),第3周实验组创面愈合,对照组仍有少量残余创面,两组有差异(p0.01)；第4、5周实验组及对照组创面均完全愈合,两组无差异(p0.05)。行免疫组化检测,CD31代表微血管密度(MVD)的结果,实验组在第1、2、3周高于对照组,第1、3周(p0.01),第2周(p0.05)；第4周实验组及对照组无明显差异(p0.05),第5周未继续测定。PCNA表达的阳性率：第1、2周实验组高于对照组(p0.01),在第3周实验组低于对照组(p0.01),第4周实验组及对照组无明显差异(p0.05),第5周未继续测定。结论：局部创面外用rhGM-CSF凝胶使新生血管化和再上皮化进程得到加快,从而提高了覆盖壳聚/葡甘聚糖生物复合膜微粒皮移植的成活率,促进了创面愈合。
[Abstract]:Objective: to evaluate whether the recombinant human granulocyte macrophage colony stimulating factor (rhGM-CSF) gel can improve the survival rate of microskin grafts by promoting wound vascularization and epithelization. To further explore a new pathway for biological composite membrane, rhGM-CSF research and clinical application. Methods: 30 experimental rabbits were randomly divided into 5 groups with 6 rabbits in each group. The thickness of 4cm 脳 4cm skin was cut off on both sides of each back, and the left and right parts were randomly divided into two groups: experimental group and control group. One tenth of the skin was removed and the skin was cut back to the wound surface. The experimental group was covered with chitosan / glucomannan composite membrane with rhGM-CSF. The control group was only covered with chitosan / glucomannan biofilm, and fixed with simple suture and thread. In the 5 groups, the wound healing status was observed at 5 weeks after operation, and the wound healing was observed by unpacking control. HE staining and immunohistochemical detection of CD31 and PCNA were performed to evaluate the repair status of the wound. Results: the wound healing rate in the experimental group was higher than that in the control group at the 1st and 2nd week after operation (p0.01), and the wound healing rate in the experimental group was higher than that in the control group at the 3rd week, and there was still a small amount of residual wound in the control group (p0.01). The wounds of the experimental group and the control group were completely healed at the 4th week, and there was no difference between the two groups (p 0.05). The results of immunohistochemical examination showed that CD31 represented microvessel density (MVD). The experimental group was higher than the control group at the 2nd week, the 1st week (p0.01) and the 2nd week (p0.05). There was no significant difference between the experimental group and the control group in the 4th week (p0. 05). The positive rate of PCNA expression in the experimental group was higher than that in the control group at the 1st week (p0. 01), and at the 3rd week it was lower in the experimental group than that in the control group (p0. 01). There was no significant difference between the experimental group and the control group at the 4th week (p 0.05). Conclusion: the application of rhGM-CSF gel can accelerate the process of neovascularization and re-epithelialization, which can improve the survival rate of coated chitosan / glucomannan biofilm microskin graft and promote wound healing.
【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R622.1

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