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.

Experimental study on the effect of hydro-gel with different contents of rhGM-CSF in promoting wound healing of deep partial thickness degree skin burns in rats

Objective： To study the therapeutic effect and to select the effective dosage Of recombinant human granulocyte/maerophage colony-stimulating factor （rhGM-CSF） incorporated in hydro-gel （Jinfelin） on wound healing. Methods： Forty-two SD rats were randomly divided into 7 groups, with 6 animals in each group： model group, vehicle group, different dosages of Jinfelin （100,250,500,750 and 1 000 mg/cm^2 ） treatment groups. Deep partial skin thickness degree burn injury was produced on both dosal sides of the body of the rats. The base gel （100 mg/cm^2 ） was used in the vehicle group on the 1st day for 10 days daily and on the 12th, 14th, 17th and 19th day after injury. The corresponding dosage of Jinfelin was used in the Jinfelin treatment groups with the same method as the vehicle group. The wound in the model group was not treated. The formation and desquamation of crust as well as the rate of epithelization and wound healing were observed and recorded on 3 rd, 7 th, 10 th, 14 th, 17 th and 21 st day. The histological examination was performed to evaluate the duration and quality of wounds healing on 21st day in different groups. Results： On 7th and 10th days decrustation was earlier in groups treated with different dosage of Jinfelin treatment significantly compared with that in model group and vehicle group,especially that of the 250-500 mg/cm^2 treatment groups（P〈0. 05） ,Meanwhile,regenerated epithelium was more profuse compared with those in model group and vehicle group（P〈0.05） ; On 14th day after treatment, regeneration rate of epithelium of 500 mg/cm^2 treatment group （55.46± 6.13）%] was still higher compared with that in model group （48. 81±4. 99） %] and vehicle group （43.17±5.65） %] and other Jirduning treatment groups （P〈0. 05）. On 10th and 14th days, wound healing rate in 250-500 mg/cm^2 Jinfelin treatment group was increased obviously compared with those in model group, vehicle group and other Jinfuning treatment groups （P〈0. 05）.On 21st day, the number of regenerated hair follicle in 250-1 000 mg/cm^2 treatment group was larger compared to model group-（1. 531±0. 374）/mm^2] and vehicel group-（1. 423±0. 346）/mm^2],especially that of the 500-750mg/cm^2 treat- ment group （7. 145± 1. 153）/mm^2 and（6. 250 ± 0. 768）/mm^2 , P%0. 051. Conelusion： rhGM-CSF hydro-gel（Jinfelin） can enhance crust formation and decrustation as well as promoting regeneration of epithelium and hair follicle, thus it can accelerate the speed of wound healing with better quality,and the most effective dose is 500 mg/cm^2.