多种生长因子促糖尿病患者难愈合性创面愈合的临床研究

目的　观察多种生长因子治疗糖尿病难愈合性创面的临床效果，并探讨其可能的机制。方法　将７８ 例糖尿病患者分为三组，即生理盐水对照组、表皮细胞生长因子（ Ｅ Ｇ Ｆ）治疗组、血小板源伤口愈合因子（ Ｐ Ｄ Ｗ Ｈ Ｆ）治疗组。观察治疗后１～８ 周创面闭合指数、创面治愈率及组织形态学变化。结果　 Ｅ Ｇ Ｆ组、 Ｐ Ｄ Ｗ Ｈ Ｆ组的创面闭合指数、创面治愈率较对照组明显增加，其肉芽组织毛细血管与成纤维细胞增生、胶原沉积和表皮覆盖明显，尤以溃疡与正常组织交界处明显。组间比较发现， Ｐ Ｄ Ｗ Ｈ Ｆ的促愈合作用优于 Ｅ Ｇ Ｆ。结论　局部应用多种生长因子可治疗糖尿病难愈合性创面，生长因子单独或配伍使用是改善糖尿病患者创面愈合受阻的有效措施。

CLINICAL STUDY OF VARIOUS GROWTH FACTORS ON THE IMPROVEMENT OF IMPAIRED HEALING ULCERS IN PATIENTS WITH DIABETIC DISEASE

Objective To investigate clinical effects and possible mechnisms of various growth factors on impaired healing ulcers of patients with diabetic disease.Methods Seventy eight patients were divided into three groups:saline control, epidermal growth factor(EGF) experimental group, and platelet derived wound healing factor (PDWHF) experimental group. General healing conditions, wound closing index, healing rates and histological changes of the patient's ulcer wound were observed during 1~8 weeks after treatment.Results The wound closing index and healing rate of ulcers were significantly increased in the EGF and PDWHF experimental groups compared with the control group, while the angiogenesis, fibroblast hyperplasia, and collagen deposit were more obvious in EGF and PDWHF experimental groups than that of control group. The promoting effects on wound healing in PDWHF experimental group were better than in EGF group.Conclusion It suggests that local application of certain growth factor alone or various growth factors together is an effective method to improve the condition of impaired healing of diabetic ulcers.