表皮生长因子在糖尿病足溃疡创面愈合过程中的作用观察及其机制探讨

目的：探讨表皮生长因子（EGF）对糖尿病足溃疡创面愈合的治疗效果及其作用机制。方法将入选的32只糖尿病足新西兰兔随机分为2组：表皮生长因子组（ A组）和对照组（ B组），每组16只。将2组实验用兔大腿部切除10 mm ×7 mm矩形区域全层皮肤，一组局部创口连续涂抹表皮生长因子（EGF），用量从始至终为1 mL，1次/d（ A组）；另一组不施加干预（ B组）。15 d后沿超出创面外缘2 mm处取下创面新生肉芽组织并作Masson染色、HE染色、电镜观察及内源性EGFmRNA检测。结果（1）光镜下A组可见大量成纤维细胞聚集成群，轮廓较清晰，细胞外基质丰富，胶原纤维束排列密集而有序，可见大量血管生成，组织分层愈合良好；B组可见创面愈合缓慢，胶原纤维稀疏，组织结构不明显。电镜下A组可见成纤维细胞体积大、形态完好、胞质内细胞器丰富，细胞周围可见大量胶原纤维排列整齐有序；B组成纤维细胞形态不规则，细胞内容物少，周围胶原纤维稀疏，排列混乱。（2）内源性EGFmRNA检测发现：A组EGFmRNA的灰度相对值为109．31±177;5．17；B组EGFmRNA的灰度相对值为61．59±177;4．61，两组比较，差异有显著性意义（P＜0．01）。结论表皮生长因子能够促进糖尿病足溃疡创面的愈合，可能机制为外源性的EGF上调了局部组织中EGFmRNA的表达。

Role and theory of epithelial growth factor in the treatment of diabetic foot ulcers

Objective To investing the mechanism of Epithelial growth factor （ EGF） in promoting diabetic foot ulcers （DFU） to heal.Methods Selected 32 New Zealand rabbits of diabetic foot were randomly assigned to two groups , EGF group （group A） and control group （group B）, 16 for each group.The all layers skin of two groups animal were removed in rectangle area of 10 mm ＆#215;7 mm.After 15 days,we taked out new flesh organize though 2 mm margin of diabetic foot ul-cers.Tissue sections of each DFU were stained by masson and trichrome HE after 15 days and observed under electron mi-croscope.EGF mRNA were detected with RT -PCR.Results Observing the group A with light microscope , a large number of fibroblasts gathered in groups ,edge sharpness ,rich in the extracellular matrix ,collagen fiber bundlingwith dense and or-derly,with a large number of angiogenesis ,organization healing welll in every layers .Group B,there were the wound healing slowly,fibroblasts sparsely,Organizational structure not obviouly .Observing the group A with electron microscope ,the fibro-blasts of group A were bigger and in good shape , organelle being rich cytoplasm .A great amount of collagen were very reg-ular surrounded the cells .The fibroblasts of group B were in irregular form ,organelle being poor .A great amount of colla-gen were very sparse surrounded the cells .EGF mRNA detection：EGFmRNA relative gray was 109.31±5.17 in group A, was 61.59 ±4.61 in group B（P〈0.01）.Conclusion EGF can promote the wound healing of DFU .Moreover, external EGF might stimulate the expression of internal EGFmRNA .