重组人酸性成纤维细胞生长因子联合夫西地酸乳膏局部应用对深Ⅱ度烧伤患者创面愈合、炎症水平、疼痛介质的影响

doi:10.3969/j.issn.1007-3205.2023.06.012

摘要/Abstract

摘要： 目的观察重组人酸性成纤维细胞生长因子联合夫西地酸乳膏局部应用对深Ⅱ度烧伤患者创面愈合、炎症水平、疼痛介质的影响。
方法选择120例深Ⅱ度烧伤患者为研究对象，以随机数字表法对患者分组，40例患者为观察组，40例患者为对照1组，40例患者为对照2组，对照1组患者给予削痂术联合重组人酸性成纤维细胞生长因子治疗，对照2组患者给予削痂术联合夫西地酸乳膏治疗，观察组患者给予削痂术联合重组人酸性成纤维细胞生长因子和夫西地酸乳膏治疗，3组患者均连续治疗至创面愈合。治疗前、后测定3组患者白细胞介素2（interleukin 2，IL-2）、干扰素γ（ interferon γ，IFN-γ）、白细胞介素10（interleukin 10，IL-10）、白细胞介素6（interleukin 6，IL-6）、5-羟色胺(5-hydroxytryptamine ，5-HT)、前列腺素E2（prostaglandin E2，PGE2）、神经肽Y（neuropeptide Y，NPY）水平，分别于治疗5 d、10 d、15 d、20 d评价3组患者肉芽生长情况，记录两患者创面愈合时间，并分别统计3组患者第10天创面愈合率、第15天创面愈合率、第20天创面愈合率、创面愈合平均时间，于创面愈合后采用温哥华瘢痕量表( Vancouver Scar Scale ,VSS)评价3组患者瘢痕增生程度，记录3组患者治疗过程中不良反应情况。
结果观察组IFN-γ、IL-6水平低于对照1组和对照2组（P＜0.05），观察组患者IL-2、IL-10水平高于对照1组和对照2组（P＜0.05），观察组PGE2、5-HT、NPY水平低于对照1组和对照2组（P＜0.05），3组患者不同时间点肉芽生长评分在时间点、组间因素和时间交互因素方面差异有统计学意义（P＜0.05），3组患者不同时间点创面愈合率在时间因素、组间因素、组间和时间交互因素方面差异有统计学意义（P＜0.05），观察组患者创面愈合平均时间、瘢痕增生评分低于对照1组和对照2组（P＜0.05），3组患者均无明显不良反应。
结论重组人酸性成纤维细胞生长因子联合夫西地酸乳膏局部应用治疗深Ⅱ度烧伤患者，可提升患者IL-2、IL-10水平，降低患者IFN-γ、IL-6、PGE2、5-HT、NPY水平，抑制患者炎症，减少患者疼痛介质，促进患者肉芽生成，促进患者愈合，减少患者瘢痕增生，安全性高。

关键词: 烧伤, 成纤维细胞生长因子, 夫西地酸乳膏

Abstract: Objective To observe the effect of recombinant human acidic fibroblast growth factor (rhaFGF) combined with fusidic acid cream on wound healing, inflammatory level and pain mediators in patients with deep second degree burn.
Methods A total of 120 patients with deep second degree burn treated in hospital were selected as the research subjects and divided into observation group (n=40), control group one (n=40) and control group two (n=40) according to random number table method. Control group one was treated with escharectomy combined with rhaFGF, control group two was treated with escharectomy combined with fusidic acid cream, and the observation group was treated with escharectomy combined with rhaFGF and fusidic acid cream. Patients in the three groups were treated continuously until wound healing. The levels of interleukin-2 (IL-2), interferon-γ (IFN-γ), interleukin-10 (IL-10), interleukin-6 (IL-6), 5-hydroxytryptamine (5-HT) , prostaglandin E2 (PGE2) and neuropeptide Y (NPY) were measured before and after treatment in the three groups. The granulation growth of the three groups was evaluated on the 5th, 10th, 15th and 20th day of treatment, and the wound healing time of the two groups was recorded. The wound healing rate on the 10th day, on the 15th day, and on the 20th day, and the average time of wound healing were recorded. After wound healing, the degree of scar hyperplasia in the three groups was evaluated by Vancouver Scar Scale (VSS), and the adverse reactions in the three groups were recorded.
Results The levels of IFN-γ and IL-6 in observation group were lower than those in control group one and control group two (P＜0.05), the levels of IL-2 and IL-10 in observation group were higher than those in control group one and control group two (P＜0.05), and the levels of PGE2, 5-HT and NPY in observation group were lower than those in control group one and control group two (P＜0.05). There were significant differences of interaction between time points, groups and time points between groups with respect to granulation growth scores (P＜0.05), and the difference of interaction between groups, time points and time points between groups were statistically significant with respect to wound healing rates (P＜0.05). The mean wound healing time and scar hyperplasia score of observation group were lower than those of control group one and control group two (P＜0.05), and there were no obvious adverse reactions in the three groups.
Conclusion rhaFGF combined with fusidic acid cream in the treatment of deep second degree burn patients can improve the levels of IL-2 and IL-10, reduce the levels of IFN-γ, IL-6, PGE22, 5-HT and NPY, inhibit inflammation, reduce pain mediators, promote granulation and healing, and reduce scar hyperplasia, with high safety.

Key words: burns, fibroblast growth factors, fusidic acid cream

王旭文, 李亮, 苏伟海, 齐杰, 生孟军. 重组人酸性成纤维细胞生长因子联合夫西地酸乳膏局部应用对深Ⅱ度烧伤患者创面愈合、炎症水平、疼痛介质的影响 [J]. 河北医科大学学报, 2023, 44(6): 681-685,691.

WANG Xu-wen, LI Liang, SU Wei-hai, QI Jie, SHENG Meng-jun. Effects of recombinant human acidic fibroblast growth factor combined with fusidic acid cream on wound healing, inflammatory level and pain mediators in patients with deep second degree burn [J]. Journal of Hebei Medical University, 2023, 44(6): 681-685,691.

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重组人酸性成纤维细胞生长因子联合夫西地酸乳膏局部应用对深Ⅱ度烧伤患者创面愈合、炎症水平、疼痛介质的影响

Effects of recombinant human acidic fibroblast growth factor combined with fusidic acid cream on wound healing, inflammatory level and pain mediators in patients with deep second degree burn

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