研究异种(猪)脱细胞真皮基质(ADM)在治疗深Ⅱ度烧伤创面过程中降低炎症反应的机理。

选取严重深Ⅱ度烧伤患者70例，按照入院时间先后顺序将其随机分成两组：实验组(n＝40)和对照组(n＝30)。实验组患者创面应用异种(猪)ADM外加无菌纱布覆盖包扎，对照组患者创面应用聚维酮碘软膏纱布覆盖包扎。以入院当天为伤后第1天算起，分别于伤后第1、3、7、10天采用放射免疫分析法和全自动化学发光分析法等技术检测血清中肿瘤坏死因子α(TNF－α)、白细胞介素－1β、白细胞介素－6和白细胞介素－10水平，同时收集伤后第3、7、10天生命体征和外周血白细胞的变化情况。采用SPSS13.0统计软件对数据进行处理，组间比较采用SNK检验。

实验组伤后第3天患者血清中TNF－α水平为(1.55±0.62)ng/mL，低于对照组(1.86±0.64)ng/mL，差异有统计学意义(P<0.05)，且生命体征的改善和外周血白细胞的变化明显优于对照组；两组患者伤后不同时间血清中白细胞介素－1β、白细胞介素－6和白细胞介素－10水平间的比较差异均无统计学意义(P值均大于0.05)。

异种(猪)ADM能降低患者血清TNF－α水平，从而减轻患者伤后全身炎症反应综合征，减少严重并发症的发生。

To discuss the mechanism of xenogenic(porcine) acellular dermal matrix (ADM) alleviating the inflammatory reaction in the process of treating deep partial thickness skin burn injury.

Seventy deep partial thickness skin burn injury patients were chosen and randomly divided into two groups. The patients in experimental group were treated with ADM while other patients were treated with povidone iodine ointment in control group. To regard the day of hospital admission as the 1st day after injury, The levels of tumor necrosis factor-alpha(TNF-α), interleukin-1beta, interleukin-6 and interleukin-10 were detected on the 1st, 3rd, 7th and 10th day post burn at all the patients and the change of patients′ vital signs as well as peripheral blood leukocyte count were monitored. SPSS 13.0 statistical software was used to process the data. Multiple comparision between groups was made using the Student-Newman-Keuls methods.

The serum TNF-α level of patients in the experimental group was(1.55±0.62) ng/mL, which was lower than that of patients in the control group on the 3rd day post burn, the difference was statistically significant (P<0.05). In addition, the vital signs and peripheral blood leukocyte count of patients in experimental group returned to normal more quickly than that of patients in the control group. However, There were no significant differences in serum levels of interleukin-1beta, interleukin-6 and interleukin-10 between the two groups at different times post burn(P values were less than 0.05).

Through lowering the level of serum TNF-α of patients, ADM is able to alleviate the postburn systemic inflammatory response syndrome and reduce the occurrence of severe complications.