重组人粒细胞/巨噬细胞集落刺激因子联合水凝胶敷料治疗深Ⅱ度烧伤创面临床观察

目的:观察外用重组人粒细胞/巨噬细胞集落刺激因子(rhGM-CSF)联合水凝胶敷料治疗深Ⅱ度烧伤创面的临床效果.方法:选择四肢部位有深Ⅱ度烧伤创面的住院患者24例,48处研究创面,每例患者2个创面,分别位于不同肢体.研究分为4组.随机选取12例患者,每例患者随机选取一个创面作为rhGM-CSF联合外用水凝胶敷料治疗组(联合治疗组,创面清创后外涂外用重组人粒细胞巨噬细胞刺激因子凝胶,覆盖医用水凝胶敷料),另一个创面作为rhGM-CSF联合外用凡士林油纱治疗组(rhGM-CSF对照组,创面清创后外涂外用重组人粒细胞巨噬细胞刺激因子凝胶,覆盖凡士林油纱);余12例患者每例随机选择一处创面作为水凝胶敷料治疗组(水凝胶对照组,创面直接覆盖医用水凝胶敷料);另一处创面作为凡士林油纱对照组(凡上林对照组,创面直接覆盖凡士林油纱).每组12处创面.观察各组创面愈合时间及创面感染情况,创面分泌物行细菌培养,比较创面细菌感染阳性率.结果:联合治疗组创面愈合时间较其他3组明显缩短(P＜0.05);rhGM-CSF对照组和水凝胶对照组创面愈合时间较凡士林对照组缩短(P＜0.05).rhGM-CSF联合外用水凝胶敷料治疗组创面洁净,细菌检出率低(16.7％):rhGM-CSF治疗组感染状况也较轻,细菌检出率较低(25.0％),凡士林对照组感染状况重,细菌检出率最高(83.3％,P＜0.01).结论:深Ⅱ度烧伤创面外用rhGM-CSF联合水凝胶敷料治疗,可以明显减少创面细菌感染概率,缩短创面愈合时间.     

重组人粒细胞巨噬细胞集落刺激因子凝胶剂对深Ⅱ度烧伤创面溶痂及愈合影响的临床研究

目的通过临床对比研究,探讨重组人粒细胞巨噬细胞集落刺激因子(recombinant human granulocyte-macrophage colony-stimulating factor,rhGMCSF)凝胶剂对深Ⅱ度烧伤创面溶痂及愈合的作用及其机制。方法以2008年12月-2010年12月收治的符合选择标准的58例深Ⅱ度烧伤患者作为试验对象。男36例,女22例;年龄12～67岁,平均32.4岁。热液烫伤38例,火焰烧伤20例。受伤至治疗时间为1～3d,平均2.1d。采用随机双盲、自身对照方法,分为给予rhGMCSF凝胶剂治疗组(试验组)及不含rhGMCSF的凝胶剂基质治疗组(对照组)。两组用药面积比较差异无统计学意义(P>0.05),具有可比性。用药后观察创面情况,于2、6、10、14、18d计算创面溶痂率,记录完全溶痂时间及创面愈合时间。结果与对照组相比,试验组用药4d后黄白色坏死组织或痂皮逐渐变软;6d后坏死组织易浮动而脱落或痂皮边缘翘起,基底红白相间,深层肉芽组织增长迅速;8d时痂皮基本溶解。用药2d后试验组创面溶痂率即高于对照组,除用药后18d,其余各时间点两组创面溶痂率比较差异均有统计学意义(P<0.05)。试验组完全溶痂时间为(7.71±2.76)d,较对照组(14.71±3.63)d明显缩短(t=13.726,P=0.000);创面愈合时间为(18.41±2.47)d,亦较对照组(23.58±3.35)d明显缩短(t=15.763,P=0.000)。结论 rhGMCSF凝胶剂与单纯凝胶剂基质相比能促进深Ⅱ度烧伤创面坏死组织脱落,加快创面愈合。     

重组人粒细胞巨噬细胞集落刺激因子在压疮护理中的应用

目的:探讨重组人粒细胞巨噬细胞集落刺激因子凝胶在Ⅱ~Ⅲ期压疮治疗护理中的临床效果。方法:选取2011年2月~2013年2月Ⅱ~Ⅲ期带压疮入院患者85例(98处),试验组应用重组人粒细胞巨噬细胞集落刺激因子凝胶治疗,对照组创面应用SD-Ag霜。分别对两组疗效、细菌存在情况及PUSH评分进行观察。结果:试验组平均愈合时间为(16.75±1.22)天,有效率96.49%,对照组平均愈合时间为(21.73±4.55)天,有效率78.05%。换药14天后,试验组的PUSH评分为(5.76±2.59)分,对照组为(8.59±3.23)分,各项指标对比均具有显著性差异(P0.01)。结论:重组人粒细胞巨噬细胞集落刺激因子凝胶能减少Ⅱ~Ⅲ期压疮创面细菌繁殖,促进肉芽组织生成,显著缩短愈合时间。     

烧伤后血粒细胞集落刺激因子的变化及其与感染的关系

作者观察了２０例烧伤患者（ＴＢＳＡ≥３０％）血清粒细胞集落刺激因子（Ｇ－ＣＳＦ）的变化，探讨了其与感染的关系。８例ＴＢＳＡ≥５０％的患者，７例出现早期Ｇ－ＣＳＦ升高；５例ＴＢＳＡ≥７０％的患者，除１例有创面脓毒症而Ｇ－ＣＳＦ无变化外，其余患者均在伤后第１天即升高；１２例ＴＢＳＡ〈５０％的患者，７例升高但为时较晚。对１１例临床诊断为创面脓毒症患者的分析表明，Ｇ－ＣＳＦ的改变与感染有关，创面脓毒症时９     

重组粒细胞集落刺激因子治疗恶性血液病口腔溃疡效果观察

恶性血液病是一组病因未明的造血系统疾病。目前,大剂量化疗能取得较好的治疗效果,但易并发口腔溃疡,给病人带来痛苦。我科2000～2001年对25例恶性血液病口腔溃疡病人应用自行配制的粒细胞集落刺激因子混和液(以下简称G-CSF混和液)局部涂搽治疗,取得满意效果。报告如下。     

重组人粒细胞集落刺激因子促进骨髓间充质干细胞增殖

目的探讨重组人粒细胞集落刺激因子(rhG-CSF)对小鼠骨髓间充质干细胞(MSCs)增殖的影响。方法将昆明小鼠随机分为2组(n=15),G-CSF组采髓前皮下注射重组人粒细胞集落刺激因子(rhG-CSF)80μg·kg-1·d-1,连用5d,对照组皮下注射等量生理盐水。每组分别于最后一次注射后6h、12h及7d(168h)取小鼠骨髓,分离、培养MSCs,计数成纤维样细胞集落形成单位(CFU-F)的个数;应用流式细胞仪检测单个核细胞(MNCs)细胞周期及CFU-F细胞表面抗原特征。结果应用rhG-CSF后,培养MNCs所获得的CFU-F数目增加(P<0.01),CFU-F数与取材时间(6h、12h、7d)呈负相关(P<0.05),但12h取材者与7d取材者比较,CFU-F数目的差异无统计学意义(P>0.05)。MNCs培养形成的CFU-F,其细胞表面抗原呈CD34-、CD133-、CD90+、CD105+,分别占2.5%、3.1%、67.0%和78.0%。G-CSF组各时间点获得的MNCs,其G0/G1期细胞百分率较对照组低(P<0.05),而S+G2/M期增高(P<0.05),且6h取材者S+G2/M期细胞百分率明显高于12h和7d取材者(P<0.05)。结论rhG-CSF可促进骨髓MNCs进入细胞增殖周期,增殖的高峰在应用G-CSF后6h左右。     

削痂植皮联合外用重组人粒细胞-巨噬细胞刺激因子修复烧伤创面效果研究

目的:探究削痂植皮手术联合外用重组人粒细胞-巨噬细胞刺激因子(Recombinant human granulocyte/macrophage colony-stimulating factor,rhGM-CSF)对烧伤患者美容效果及满意率影响。方法:研究共计纳入125例烧伤患者,均为笔者医院2016年1月-2019年1月收治,采取随机数字表法将患者分为观察组和对照组,对照组患者(62例)采取削痂植皮手术治疗,观察组患者(63例)削痂植皮手术联合外用重组人粒细胞-巨噬细胞刺激因子治疗,比较两组患者美容效果、创面愈合时间及创面疼痛评分[视觉模拟疼痛法(Visual analogue scale,VAS)]、创面炎症评分及治疗前后创面边缘炎症因子白细胞介素1β(IL-1β)、肿瘤坏死因子α(TNF-α)水平变化、患者治疗满意率。结果:观察组患者美容效果有效率(80.95%)高于对照组(64.52%),差异有统计学意义(P<0.05)。观察组患者创面炎症评分及VAS疼痛评分均优于对照组,创面愈合时间短于对照组,差异有统计学意义(P<0.01)。治疗前,两组患者创面边缘炎症因子(IL-1β、TNF-α)水平比较差异无统计学意义(P>0.05);治疗后各组患者IL-1β、TNF-α水平下降,观察组IL-1β、TNF-α水平低于对照组,差异有统计学意义(P<0.05)。观察组患者治疗满意率(95.24%)显著高于对照组(83.87%),差异有统计学意义(P<0.05)。结论:削痂植皮手术联合外用重组人粒细胞-巨噬细胞刺激因子可提升烧伤患者临床疗效,美容效果佳,患者恢复好,疼痛轻,满意率高,值得推广以及应用。     

不同剂量rhGM-CSF凝胶促进大鼠深Ⅱ度烧伤创面愈合的实验研究

目的：观察不同剂量重组人粒细胞-巨噬细胞集落刺激因子（rhGM-CSF）凝胶（商品名为金扶宁）对SD大鼠深Ⅱ度烫伤创面愈合的促进作用并筛选最佳剂量.方法：42只SD大鼠,雌雄各半,随机分为7组：模型组,凝胶基质对照组,金扶宁100、250、500、750和1 000 mg/cm^2治疗组.每只大鼠背部制备两个深Ⅱ度烫伤创面,凝胶基质对照组创面于伤后1～10 d每日涂抹凝胶基质100 mg/cm^2,然后于伤后12、14、17和19 d间断创面涂抹凝胶基质100 mg/cm^2;不同剂量金扶宁治疗组创面涂沫相应剂量金扶宁,给药方法及时间同凝胶基质对照组;模型组不予处理.伤后3、7、10、14、17、21 d分别测量痂皮形成及脱落创面数,计算创面上皮化率、创面愈合率,伤后21 d行组织学检查.结果：与模型组和凝胶基质对照组相比,金扶宁各组对烫伤后7～10 d前后创面的融痂脱痂效果非常明显,以250～500 mg/cm^2治疗组疗效最佳（P〈0.05）.治疗后7～10 d,金扶宁各组新生上皮较模型组和凝胶基质对照组均显著增多（P〈0.05）;治疗后14 d,金扶宁500 mg/cm^2治疗组上皮化率[（55.46±6.13）%]较模型组[（48.81±4.99）%]和凝胶基质对照组[（43.17±5.65）%]仍然显著增多,并优于其他剂量治疗组（P〈0.05）.治疗后10～14 d,金扶宁250～500 mg/cm2治疗组创面愈合率较模型组、凝胶基质对照组和其他剂量治疗组显著增高（P〈0.05）;治疗后21 d,金扶宁250～1 000 mg/cm^2治疗组毛囊再生数量较模型组[（1.531±0.374）/mm2]和凝胶基质对照组[（1.423±0.346）/mm^2]显著增高,以500～750 mg/cm^2治疗组[分别为（7.145±1.153）/mm2和（6.250±0.768）/mm2]明显（P〈0.05）.结论：rhGM-CSF凝胶可以促进痂皮形成和脱落、加快上皮生长、促进毛囊再生,增加烧伤创面修复速度并改善修复质量,以500 mg/cm^2剂量治疗效果最佳.     

前列腺癌粒细胞-巨噬细胞集落刺激因子受体表达的研究

目的 :研究粒细胞 巨噬细胞集落刺激因子 (GM CSF)受体在前列腺癌组织和 4种肿瘤细胞株中的表达及其意义。　方法 :应用SP免疫组织化学方法研究 4 8例前列腺癌和 2 0例良性前列腺增生石蜡标本中GM CSF受体α亚单位表达 ;Western印迹方法检测慢性粒细胞性白血病细胞株K5 6 2 ,乳腺癌细胞株MCF 7,转移性前列腺癌细胞株PC 3M和急性早幼粒细胞性白血病细胞株HL 6 0GM CSF受体α亚单位的表达。　结果 :4 8例前列腺癌中GM CSF受体α亚单位表达阳性病例 38例 ,阳性率为 79.2 %。其中Gleason 2～ 4分者 15例 ,5～ 8分 14例 ,9～ 10分 9例 ,GM CSF受体的阳性率与前列腺癌Gleason评分相关 ;2 0例良性前列腺增生中GM CSF受体α亚单位表达 6例 ,阳性率为 30 .0 %。 4种肿瘤细胞株K5 6 2、HL 6 0、PC 3M和MCF 7均表达GM CSF受体α亚单位。　结论 :GM CSF受体表达是前列腺癌的重要特征 ,GM CSF可能参与前列腺癌的增殖过程。     

Recombinant human granulocyte-macrophage colony-stimulating factor hydrogel promotes healing of deep partial thickness burn wounds

Objective

To assess the effects of recombinant human granulocyte/macrophage colony-stimulating factor (rhGM-CSF) hydrogel on the healing of deep partial thickness burn wounds.

Methods

Ninety three wounds of 65 burn patients who suffered from a deep partial thickness burn of <5% TBSA and could not heal over 3 weeks were included in this study. The patients were randomly assigned to use rhGM-CSF hydrogel (GC group, n = 32) or hydrogel without rhGM-CSF (control group, n = 33). rhGM-CSF hydrogel or hydrogel without rhGM-CSF was topically applied to the wounds, the dressing was changed once a day. Wound healing time and percentage, wound discharge, periwound inflammation, the positive wound swabs culture count, and adverse drug reactions were observed and compared between two groups.

Results

Healing time was 12.2 ± 5.0 days after the application of rhGM-CSF hydrogel. This was significantly shorter than that of control wounds (15.5 ± 4.7 days). Healing percentage at 14 days in the rhGM-CSF-treated wounds was 97.5 ± 7.7%, which was markedly higher than the control (85.9 ± 6.8%). At 3, 6, 12, 14 day, the GC group was significantly superior to the control group with respect to the score of periwound inflammation, wound purulence and discharge. The positive wound swabs culture count of the GC group on the 7th and 14th day post-treatment was 14 and 4, respectively, which was significantly lower than the control.

Conclusion

rhGM-CSF hydrogel promotes the healing process of deep partial thickness burns effectively. No adverse reaction of the drug was observed during the study.     

大鼠浅度烫伤创面愈合与相关生长因子及受体的基因表达

目的探讨浅Ⅱ度烧伤创面愈合过程中相关生长因子及其受体的作用。方法采用大鼠浅Ⅱ度烫伤模型,观察了大鼠浅Ⅱ度烫伤后创面愈合过程中组织学、炎性细胞、表皮细胞周期的变化,检测了创面相关生长因子及受体的基因表达。结果炎性细胞到达创面依次为中性粒细胞、巨噬细胞和淋巴细胞;表皮细胞周期变化为伤后3天细胞增殖活跃,伤后7天细胞分裂明显增多;伤后1,3天 PDGF(血小板源性生长因子)、PDGFR(血小板源性生长因子受体)和 EGFR(表皮生长因子受休)基因表达明显增强,伤后3,5天 EGF(表皮生长因子)、TGFβ-R_2(转化生长因子β受体α)基因表达增强,伤后5,7天 TGFβ-R_1(转化生长因子β受体1)基因表达增强,伤后7,10天 TGFβ_1(转化生长因子β)基因表达增强。结论烧伤诱导相关生长因子及受体的基因表达,并且具有时相性和可逆性;相关生长因子基因表达与表皮细胞周期间可能存在相互调控作用,生长因子是调控创面愈合的主要因素。     

荷负电气溶胶治疗Ⅱ度烧伤创面的临床效果及病理学观察

目的观察荷负电气溶胶(下称气溶胶)治疗Ⅱ度烧伤创面的效果。方法选择单纯浅Ⅱ、深Ⅱ度烧伤患者,随机分为:(1)气溶胶组:浅Ⅱ度180例、深Ⅱ度100例,伤后6h~2d开始用气溶胶治疗创面,l~2次/d,1.5h/次。(2)对照组:浅Ⅱ、深Ⅱ度患者各30例,常规治疗。(3)自身对照组:浅Ⅱ、深Ⅱ度患者各10例,同上用气溶胶治疗,但同一患者部分创面覆盖无菌金属片屏蔽气溶胶(屏蔽组),部分创面不屏蔽(非屏蔽组)。观察气溶胶治疗过程中患者创面的大体变化,治疗前后进行创面细菌培养,并监测其肝、肾功能及血生化指标有无改变。记录各组患者创面愈合时间。另制作深Ⅱ度烫伤大鼠模型,同前分为气溶胶组和对照组并治疗。取两组大鼠治疗前及治疗后1、2、3周的创面组织标本,作病理学观察。结果气溶胶治疗后患者创面渗出少,治疗前后均无细菌生长。总体来讲,气溶胶治疗前后患者肝、肾功能及血生化指标无明显改变。气溶胶组患者浅Ⅱ度创面伤后(6.3±1.6)d愈合,深Ⅱ度创面(15.1±3.1)d愈合,明显短于对照组相同深度创面[(11.3±1.4)、(21.2±1.4)d,P<0.01]。自身对照组中,相同烧伤深度的非屏蔽组与屏蔽组比较,创面愈合时间也明显缩短(P<0.01)。病理学检查显示,气溶胶组大鼠治疗后第3周皮肤结构已基本恢复正常,而对照组此时恢复较差。结论气溶胶能有效促进Ⅱ度烧伤创面的愈合且使用安全。     

大鼠浅度烫伤创面愈合与相关生长因子及受体的基因表达

目的探讨浅Ⅱ度烧伤创面愈合过程中相关生长因子及其受体的作用。方法采用大鼠浅Ⅱ度烫伤模型,观察了大鼠浅Ⅱ度烫伤后创面愈合过程中组织学、炎性细胞、表皮细胞周期的变化,检测了创面相关生长因子及受体的基因表达。结果炎性细胞到达创面依次为中性粒细胞、巨噬细胞和淋巴细胞;表皮细胞周期变化为伤后３天细胞增殖活跃,伤后７天细胞分裂明显增多;伤后１,３天ＰＤＧＦ（血小板源性生长因子）、ＰＤＧＦＲ（血小板源性生长因子受体）和ＥＧＦＲ（表皮生长因子受体）基因表达明显增强,伤后３,５天ＥＧＦ（表皮生长因子）、ＴＧＦβＲ２（转化生长因子β受体α）基因表达增强,伤后５,７天ＴＧＦβＲ１（转化生长因子β受体１）基因表达增强,伤后７,１０天ＴＧＦβ１（转化生长因子β）基因表达增强。结论烧伤诱导相关生长因子及受体的基因表达,并且具有时相性和可逆性;相关生长因子基因表达与表皮细胞周期间可能存在相互调控作用,生长因子是调控创面愈合的主要因素。     

Implications of chlorhexidine use in burn units for wound healing

Chlorhexidine is known to be a potent antiseptic with evidence of a beneficial role in burn care. Nevertheless, several in vitro studies have reported cytotoxicity on cultured cells, while in vivo and clinical data seem to show more controversial results. In the frame of this work, we aimed to evaluate the use of chlorhexidine in burn units worldwide be sending a survey to professionals of the field. We associated survey results to those perspectives reported in the literature to update recommendations for the use of chlorhexidine in specific protocols for burn management. The survey results showed that there is no clear consensus on the use of chlorhexidine regarding the concentrations, the type of excipient and the cleansing after application. Literature searches showed evidence that the skin of premature infants appears to be more sensitive to chlorhexidine that adult skin, with more reported cases of adverse effects. It was also determined that aqueous formulations of chlorhexidine do not appear to be necessarily less efficient than with alcohol as an excipient, and that lower concentrations are as efficient as higher concentrations. In view of this study, we have adjusted our protocols for the use of aqueous formulations at low concentrations and investigated further the role of washing after application in order to standardize the indication of chlorhexidine and minimize the probability of adverse effects.     

单核细胞集落刺激因子缺失对小鼠创面愈合与新生血管化的影响

目的观察单核细胞集落刺激因子(GMCSF)缺失对创面愈合率和创面愈合过程中新生血管化程度的影响,并分析其机理。方法取GMCSF基因缺失小鼠(GMCSF-/-)和野生小鼠(WT)各30只,麻醉后背部致创(0.8cm×0.8cm),伤后在不同时相点摄像并取创面标本。通过计算机图像处理系统计算创面愈合率,用免疫组织化学方法通过测定创面CD31的阳性表达来计算新生血管数目。结果GMCSF基因缺失的小鼠创面愈合率从伤后3d起就明显低于野生小鼠。伤后第7天起,GMCSF-KO组小鼠CD31的阳性率明显低于WT组。结论GMCSF基因缺失影响创面的新生血管化能力,进而影响创面的愈合。     

Effects of mesenchymal stem cells transfected with human hepatocyte growth factor gene on healing of burn wounds

Objective： To explore the effects of bone marrow-derived mesenchymal stem cells （BMSCs）transfected with adenoviral vector carrying hepatocyte growth factor （HGF, Ad-HGF） on burn wound healing.Methods： BMSCs from male Wistar rats were separated and purified with Percoll separating medium by density gradient centrifugation and cultured with DMEM containing 20% fetal bovine serum （FBS）. Then BMSCs were transfected with Ad-HGF at the optimal gene transduction efficiency of 100 multiplicity of infection （MOI）. The efficiency of transfection and the expression of HGF in the suspension were detected by flow cytometry and enzyme linked immunosorbent assay （ELISA） respectively. Thirtytwo female rats were subjected to 90℃ water for 12 seconds to induce a partial thickness skin burn. The animals were randomly divided into mesenchymal stem cells （MSCs） treatment group （Group A）, Ad-HGF treatment group （Group B）,Ad-HGF-modified MSCs treatment group （Group C） and saline control group （Group D）. On days 3, 5, 7, 14 and 21 postburn, HE and Sirius red stain were performed to observe the burn wound healing and collagen content. The content of hydroxyproline in wounds was also detected.Transplanted cells and the expression of（sex-determining region Y） SRY gene were detected by in situ hybridization and polymerase chain reaction （PCR）, while the expression of HGF in wound tissues was detected by ELISA.Results： The result of flow cytometry showed that the transfection efficiency was 86.41% at 100 MOI. Compared with the control group, the content of HGF in the supernatant after transfection increased time-dependently and peaked at 48 h, showing significant differences at 24 h, 48 h,72 h and 96 h （P＜0.01 ）. Results of HE stain revealed that the range of re-epidermidalization in Group C was significantly larger than that in other groups in the first week. Three weeks postburn, the epidermis was significantly thicker in Group C than in other groups and the nails of dermis inserted into the derma of burn wounds. Sirius red stain showed that the content of collagen Ⅰ in Group C was much less compared with that in other groups 21 days postburn. In situ hybridization revealed an expression of SRY gene in burned female rats, consistent with the finding of PCR. Immunohistochemistry demonstrated the largest increase of HGF expression in Group C, whose contents of hydroxyproline,however, decreased on day 7 postburn. Compared with other groups, the content of HGF in the wounds of Group C increased obviously on day 14 after transfection （P＜0.05） and there was no significant difference among Groups A, B and D.Conclusion： Our study suggests that transplantation of MSCs modified with Ad-HGF has positive effects on the healing of burn wounds probably through differentiation and release of relevant cytokines.     

β内啡肽与μ型-阿片受体在深Ⅱ度烫伤大鼠创面愈合过程中的表达

目的观察β内啡肽和μ型-阿片受体（MOR）在深Ⅱ度烫伤大鼠创面愈合过程中的表达。方法将36只Wistar大鼠随机分为对照组（6只）、烫伤组（30只）。烫伤组大鼠被造成5％TBSA深Ⅱ度烫伤，对照组仅模拟烫伤。于伤后即刻及伤后3、7、14、21d取创面组织，采用免疫荧光标记法检测B内啡肽和MOR的表达情况。结果对照组大鼠皮肤组织内β内啡肽和MOR主要分布于表皮、真皮交界的周围神经纤维、表皮的角质形成细胞、真皮的成纤维细胞中，强度较弱。伤后3d，烫伤组B内啡肽表达达峰值（196±16，P＜0．01），在皮肤全层均有表达；MOR集中表达在基底层和基底上的角质形成细胞。伤后7、14d烫伤组B内啡肽仍大量表达。伤后7d，烫伤组MOR的表达进一步增强，胶原排列紊乱；14d时部分创面再上皮化，MOR表达达高峰（306±23，P＜0．01）。伤后21d，烫伤组创面完全再上皮化，周围神经末梢接近并抵达表皮、真皮交界，胶原排列较整齐，β内啡肽的表达（31±24）与对照组（30±18）接近；但MOR的表达（56±16）仍然高于对照组（28±15）。结论烫伤后β内啡肽和MOR的表达具有一定的时效性，这种变化可能影响了创面愈合。