CAJ | 학술논문

目的：比较重组人粒细胞-巨噬细胞集落刺激因子（ rhGM-CSF）与纳米银敷料对深Ⅱ度烫伤创面愈合过程的影响。方法用Wistar大鼠建立深Ⅱ度烫伤模型，分为A、B、C 3组，A组（ n＝30）：凡士林纱布覆盖；B组（n＝30）：纳米银敷料覆盖；C组（n＝30）：rhGM-CSF涂抹创面。分别于伤后第1、4、7、10、14、21天，观察创面炎症反应，计算愈合率，细菌培养并计数。结果 A、B、C 3组均在第10天出现明显的血管化和上皮化，A组创面伤后红肿明显，并且在第14天出现痂下积脓，向皮下潜行，切片可见大量炎性细胞浸润、聚集、迁移，血管壁通透性增加，血管化和上皮化进程较慢；B、C组创面伤后红肿，在伤后第4天炎症反应最重，切片可见炎性细胞浸润、聚集、迁移，血管壁通透性增加，血管化和上皮化进程较A组明显加快，至第14天因为创面溶痂，炎症反应较前略有加重。创面愈合率方面，C组＞B组＞A组，第14、21天，差异有统计学意义（ P＜0.05）。 A组和B组、C组分别于伤后第4和10天出现细菌生长，第10、14、21天，B组、C组比A组细菌生长数量减少，差异有统计学意义（ P＜0.05），而B组、C组之间差异无统计学意义（P＞0.05）；革兰阳性菌以金黄色葡萄球菌居首位，革兰阴性菌以铜绿假单胞菌居首位。结论 rhGM-CSF和纳米银敷料外用，均能减少深Ⅱ度烫伤创面细菌生长，减轻炎症反应；促进创面愈合方面，rhGM-CSF优于纳米银敷料。
목적：비교중조인립세포-거서세포집락자격인자（ rhGM-CSF）여납미은부료대심Ⅱ도탕상창면유합과정적영향。방법용Wistar대서건립심Ⅱ도탕상모형，분위A、B、C 3조，A조（ n＝30）：범사림사포복개；B조（n＝30）：납미은부료복개；C조（n＝30）：rhGM-CSF도말창면。분별우상후제1、4、7、10、14、21천，관찰창면염증반응，계산유합솔，세균배양병계수。결과 A、B、C 3조균재제10천출현명현적혈관화화상피화，A조창면상후홍종명현，병차재제14천출현가하적농，향피하잠행，절편가견대량염성세포침윤、취집、천이，혈관벽통투성증가，혈관화화상피화진정교만；B、C조창면상후홍종，재상후제4천염증반응최중，절편가견염성세포침윤、취집、천이，혈관벽통투성증가，혈관화화상피화진정교A조명현가쾌，지제14천인위창면용가，염증반응교전략유가중。창면유합솔방면，C조＞B조＞A조，제14、21천，차이유통계학의의（ P＜0.05）。 A조화B조、C조분별우상후제4화10천출현세균생장，제10、14、21천，B조、C조비A조세균생장수량감소，차이유통계학의의（ P＜0.05），이B조、C조지간차이무통계학의의（P＞0.05）；혁란양성균이금황색포도구균거수위，혁란음성균이동록가단포균거수위。결론 rhGM-CSF화납미은부료외용，균능감소심Ⅱ도탕상창면세균생장，감경염증반응；촉진창면유합방면，rhGM-CSF우우납미은부료。
Objective To compare the effects of recombinant human granulocyte /macrophage colonystimulating factor (rhGM-CSF) and nano-silver as treatment for degreed Ⅱdeep burn.Methods The degreedⅡdeep burn mod-el were constructed with Wistar rats , which were randomly divided into 3 groups, petrolatum treatment ( Group A, n=30), nano-silver treatment (Group B, n=30) and rhGM-CSF treatment (Group C, n=30).The inflammatory reac-tion, healing rate and culture bacteria on wound were observed on the 1st, 4th, 7th, 10th, 14th and 21st day after treatment. Results Vasculization and epithelizaiton were observed in all the 3 groups on the 10 th day.Obvious redness and swollen were observed in Group A , with abscess under scab and infiltrated subcutaneously , and mass inflammatory cells , in-creased vascular penetration and slow vasculizatoin and epitheliztion were also observed .These were suppressed in Group B and C.Significantly highest healing rates were observed in Group C , followed by Group B and Group A on the 14th and 21st day (P<0.05).Bacteria were found in Group A and B on the 4th day, while on the 10th day in Group C.Significant-ly less bacteria were observed in Group B or C than those in Group A on the 10th, 14th and 21st day (P<0.05), while there was no significant difference between Group B and C (P>0.05).Conclusion The rhGM-CSF and nano-silver treatment can reduce bacteria growth and alleviate inflammatory reaction .And rhGM-CSF provides better efficacy on pro-moting wound healing than nano -silver.