切换至 "中华医学电子期刊资源库"
高级检索
中华损伤与修复杂志(电子版)

中华损伤与修复杂志(电子版) ›› 2017, Vol. 12 ›› Issue (03) : 187 -190. doi: 10.3877/cma.j.issn.1673-9450.2017.03.006

所属专题： 文献；

论著

异种(猪)脱细胞真皮基质降低深Ⅱ度烧伤炎症反应的实验研究
林颜1, 杨荣华1, 阮树斌1, 林泽鹏1, 冯祥生1, 沈锐1, 张凤刚1, 熊想莲1, 陈晓东1,†()   
  1. 1. 528000　中山大学附属佛山医院烧伤整形创面修复外科
  • 收稿日期:2017-03-18 出版日期:2017-06-01
  • 通信作者: 陈晓东
  • 基金资助:
    国家自然青年基金(81401604); 2014年佛山市卫生局立项资助(2014032)

Clinical study of reducing the inflammatory response in deep partial thickness skin burns under the treatment of xenogeneic (porcine) acellular dermal matrix

Yan Lin1, Ronghua Yang1, Shubin Ruan1, Zepeng Lin1, Xiangsheng Feng1, Rui Shen1, Fenggang Zhang1, Xianglian Xiong1, Xiaodong Chen1,†()   

  1. 1. Department of Burn Surgery, the First People′s Hospital of Foshan, Foshan 528000, China
  • Received:2017-03-18 Published:2017-06-01
  • Corresponding author: Xiaodong Chen
  • About author:
    Corresponding author: Chen Xiaodong, Email:
全文 ( ) 下载PDF ( ) 导出引用
引用本文：

林颜, 杨荣华, 阮树斌, 林泽鹏, 冯祥生, 沈锐, 张凤刚, 熊想莲, 陈晓东. 异种(猪)脱细胞真皮基质降低深Ⅱ度烧伤炎症反应的实验研究[J]. 中华损伤与修复杂志(电子版), 2017, 12(03): 187-190.

Yan Lin, Ronghua Yang, Shubin Ruan, Zepeng Lin, Xiangsheng Feng, Rui Shen, Fenggang Zhang, Xianglian Xiong, Xiaodong Chen. Clinical study of reducing the inflammatory response in deep partial thickness skin burns under the treatment of xenogeneic (porcine) acellular dermal matrix[J]. Chinese Journal of Injury Repair and Wound Healing(Electronic Edition), 2017, 12(03): 187-190.

目的

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。

方法

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。

结果

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)。

结论

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。

关键词: 烧伤, 系统性炎症反应综合征, 细胞因子类, 异种(猪)脱细胞真皮基质
Objective

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.

Methods

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.

Results

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).

Conclusions

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.

Key words: Burns, Systemic inflammatory response syndrome, Cytokines, Xenogeneic(porcine) acellular dermal matrix
表1 两组患者伤后不同时间血清TNF-α水平的变化(ng/mL，±s)
组别 例数 伤后第1天 伤后第3天 伤后第7天 伤后第10天
对照组 26 1.24±0.48 1.86±0.64 1.54±0.55 1.47±0.74
实验组 40 1.21±0.43 1.55±0.62a 1.44±0.56 1.26±0.55
1
冯祥生,潘银根,谭家驹, 等. 异种(猪)脱细胞真皮基质一次性包扎治疗深Ⅱ度烧伤[J]. 中华外科杂志, 2006, 44(7): 467-470.
2
Wang B,Trayhurn P. Acute and prolonged effects of TNF-alpha on the expression and secretion of inflammation-related adipokines by human adipocytes differentiated in culture[J]. Pflugers Arch, 2006, 452(4): 418-427.
3
Bone RC. Immunologic dissonance: a continuing evolution in our understanding of the systemic inflammatory response syndrome (SIRS) and the multiple organ dysfunction syndrome (MODS)[J]. Ann Intern Med, 1996, 125(8): 680-687.
4
Bhatia M,Moochhala S. Role of inflammatory mediators in the pathophysiology of acute respiratory distress syndrome[J]. J Pathol, 2004, 202(2): 145-156.
5
Yeh FL,Lin WL,Shen HD, et al. Changes in serum tumour necrosis factor-alpha in burned patients[J]. Burns, 1997, 23(1): 6-10.
6
Bhatia M. Novel therapeutic targets for acute pancreatitis and associated multiple organ dysfunction syndrome[J]. Curr Drug Targets Inflamm Allergy, 2002, 1(4): 343-351.
7
Fiorentino DF,Zlotnik A,Mosmann TR, et a1. IL-10 inhibits cytokine production by activated macrophages[J]. J Immunol, 1991, 147(11): 3815-3822.
8
Smith SR,Terminelli C,Kenworthy-Bott L, et a1. The cooperative effects of TNF-alpha and IFN-gamma are determining factors in the ability of IL-10 to protect mice from lethal endotoxemia[J]. J Leukoc Biol, 1994, 55(6): 711-718.
9
van der Poll T,Jansen PM,Montegut WJ, et a1. Effects of IL-10 on systemic inflammatory responses during sublethal primate endotoxemia[J]. J Immunol, 1997, 158(4): 1971-1975.
10
Zhang B,Huang YH,Chen Y, et a1. Plasma tumor necrosis factor-alpha, its soluble receptors and interleukin-1beta levels in critically burned patients[J]. Burns, 1998, 24(7): 599-603.
11
Gosain A,Gamelli RL. A primer in cytokines[J]. J Burn Care Rehabil, 2005, 26(1): 7-12.
12
Biffl WL,Moore EE,Moore FA, et a1. Interleukin-6 in the injured patient. Marker of injury or mediator of inflammation？[J]. Ann Surg, 1996, 224(5): 647-664.
13
Hunt TK. Basic principles of wound healing[J]. J Trauma, 1990, 30(12 Suppl): S122-S128.
14
Johnson D,Mayers I. Multiple organ dysfunction syndrome: a narrative review[J]. Can J Anaesth, 2001, 48(5): 502-509.
15
Feng X,Tan J,Pan Y, et a1. Control of hypertrophic scar from inception by using xenogenic (porcine) acellular dermal matrix (ADM) to cover deep second degree burn[J]. Burns, 2006, 32(3): 293-298.
[1] 李文金, 薛庆云. 白细胞介素家族炎性细胞因子在骨关节炎中的研究进展[J]. 中华关节外科杂志(电子版), 2023, 17(03): 348-353.
[2] 姚咏明. 如何精准评估烧伤脓毒症患者免疫状态[J]. 中华损伤与修复杂志(电子版), 2023, 18(06): 552-552.
[3] 涂家金, 廖武强, 刘金晶, 涂志鹏, 毛远桂. 严重烧伤患者鲍曼不动杆菌血流感染的危险因素及预后分析[J]. 中华损伤与修复杂志(电子版), 2023, 18(06): 491-497.
[4] 王成, 张慧君, 覃凤均, 陈辉. 网状植皮与ReCell表皮细胞种植在深Ⅱ度烧伤治疗中的疗效对比[J]. 中华损伤与修复杂志(电子版), 2023, 18(06): 498-502.
[5] 中华医学会烧伤外科学分会小儿烧伤学组. 儿童烧伤早期休克液体复苏专家共识(2023版)[J]. 中华损伤与修复杂志(电子版), 2023, 18(05): 371-376.
[6] 蔡柔妹, 曾洁梅, 黄伟丽, 谢文敏, 刘燕丹, 吴漫君, 蔡楚燕. 利用QC小组干预降低经烧伤创面股静脉置管导管相关性感染发生率的临床观察[J]. 中华损伤与修复杂志(电子版), 2023, 18(05): 399-404.
[7] 茹天峰, 戴浩楠, 袁林, 吴坤平, 谢卫国. 对肌肉超声在严重烧伤患者肌肉性能评估中应用的效果观察[J]. 中华损伤与修复杂志(电子版), 2023, 18(03): 197-203.
[8] 杨姣, 王玲, 古兰, 安慎通, 胡大海, 韩军涛. 对艾司氯胺酮在烧伤后瘢痕手术患儿静脉穿刺中的应用效果观察[J]. 中华损伤与修复杂志(电子版), 2023, 18(03): 210-216.
[9] 李峰, 黎君友, 冯书堂, 李国平, 杨洁蓉. 对GGTA1/β4GalNT2双基因敲除近交系五指山小型猪皮进行异种移植的效果观察[J]. 中华损伤与修复杂志(电子版), 2023, 18(03): 241-248.
[10] 刘晓彬, 朱峰. 危重烧伤患者肾功能亢进的药物治疗[J]. 中华损伤与修复杂志(电子版), 2023, 18(03): 260-264.
[11] 李东杰, 贾晓明. 加强研究皮肤低温损伤机制以提高皮肤储存质量[J]. 中华损伤与修复杂志(电子版), 2023, 18(02): 93-97.
[12] 何泽亮, 李锦, 张程亮, 随振阳, 安亮恩, 刘玲玲, 姚媛媛, 张聚磊, 仇树林, 李晓东. 采用超声清创联合负压吸引疗法治疗深度烧伤溶痂创面的临床观察[J]. 中华损伤与修复杂志(电子版), 2023, 18(02): 123-127.
[13] 许磊, 孙杰, 陈先志, 张家泉, 李旺勇, 冯其柱, 王琦. 血液净化治疗在高血脂性重症胰腺炎中的应用[J]. 中华肝脏外科手术学电子杂志, 2023, 12(04): 464-468.
[14] 王燕, 郭蕊, 王淑杰. 老年烧伤气管切开患者死亡风险诊断模型构建及对策分析[J]. 中华诊断学电子杂志, 2023, 11(04): 249-253.
[15] 高雷, 李全, 巴雅力嘎, 陈强, 侯智慧, 曹胜军, 巴特. 重度烧伤患者血小板外泌体对凝血功能调节作用的初步研究[J]. 中华卫生应急电子杂志, 2023, 09(03): 149-154.
阅读次数
全文


摘要

版权所有 中华医学会 中华医学电子音像出版社有限责任公司  京ICP备14006079号-1  网络出版服务许可证：(署)网出证(京)字第075号