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。
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 ×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 .