烧伤患者肢体Ⅲ度创面组织恢复过程中EPO、TGFβ1及受体表达-东南大学学报医学版

烧伤患者肢体Ⅲ度创面组织恢复过程中EPO、TGFβ1及受体表达

单位：四川省成都市郫都区人民医院第五外科, 四川成都 611730

分类号：R644

出版年·卷·期（页码）：2019·38·第一期（118-125）

摘要：

目的：考察烧伤患者肢体Ⅲ度创面组织恢复过程中促红细胞生成激素（EPO）、转化生长因子-β1（TGF-β1）及受体表达。方法：选择2014年5月至2017年12月在我院收治的106例单个肢体Ⅲ度烧伤患者为研究对象。愈合时间为2.0~9.5周，中位数6.0周，以所有患者的愈合时间的中位数为界，分为2组，愈合快组和愈合慢组，各53例。结果：两组随着时间的延长均有不同程度地愈合（P<0.05），与愈合慢组比，愈合快组每周的愈合面积均较高（P<0.05）。除了愈合时间，两组患者的性别、年龄、烧伤原因、手术距离烧伤后的时间、患肢、高血压、高血脂、其他心脑血管疾病及0周时烧伤组织的EPO、EPO受体、TGF-β1、TβRI及TβRⅡ表达差异均无统计学差异（P>0.05），与愈合慢组比，愈合快组的年龄、糖尿病例数、烧伤面积和手术面积较少，4周时烧伤组织的EPO、EPO受体、TGF-β1、TβRI及TβRⅡ较高（P<0.05），以愈合快慢为因变量，以年龄、糖尿病例数、烧伤面积、手术面积、4周时烧伤组织的EPO、EPO受体、TGF-β1、TβRI及TβRⅡ为自变量，进行Logistic回归分析，年龄、4周时烧伤组织的EPO、EPO受体、TGF-β1、TβRI及TβRⅡ可影响肢体Ⅲ度创面组织愈合，年龄越小，4周时烧伤组织的EPO、EPO受体、TGF-β1、TβRI及TβRⅡ表达越高，肢体Ⅲ度创面组织愈合越快（P<0.05）。两组创面组织的EPO、EPO受体、TGF-β1、TβRI及TβRⅡ 0周的表达相当（P>0.05），到2周时，EPO、EPO受体、TGF-β1、TβRI及TβRⅡ均增高（P<0.05），到4周时，EPO、EPO受体、TGF-β1、TβRI及TβRⅡ均降低（P<0.05），与愈合慢组比，愈合快组2周和4周的EPO、EPO受体、TGF-β1、TβRI及TβRⅡ均明显增高（P<0.05）。结论：肢体Ⅲ度创面组织的EPO、EPO受体、TGF-β1、TβRI及TβRⅡ表达与愈合明显相关，EPO、EPO受体、TGF-β1、TβRI及TβRⅡ表达较高，创伤愈合较快。

Objective:To investigate the expression of erythropoietin (EPO), transforming growth factor-β1 (TGF-β1) and their receptors during the restoration of wounds in third-degree burn patients. Methods:From May 2014 to December 2017 in our hospital, 106 cases of single limb third-degree burn patients were selected as the research objects. According to the median of all patients' healing time (2 weeks~9.5 weeks, the median was 6.0weeks), the patients were divided into fast healing group and slow healing group, 53 cases in each group. Results:Both groups healed to different extents (P<0.05). Compared with the slow healing group, the healed area of the healing group was bigger in the fast healing group (P<0.05). Except healing time, the sex, age, healing reasons, the healing limb, hypertension, hyperlipidemia and other cardiovascular diseases, the expression of EPO, EPO receptor, TGF-β1, TβRI and TβRⅡ in wound tissue of 0 week in both groups had no differences (P>0.05). Compared with the slow healing group, the age, hyperlipidemia, the area of wound and surgery area were smaller (P<0.05), the expression of EPO, EPO receptor, TGF-β1, TβRI and TβRⅡ in wound tissue of 4 weeks were higher in the fast healing group (P<0.05). The slow or the fast healing were as the dependent variables, the age, hyperlipidemia, the area of wound and surgery area, the expression of EPO, EPO receptor, TGF-β1, TβRI and TβRⅡ in wound tissue of 4 weeks as the independent variables for logistical analyze. The age, the expression of EPO, EPO receptor, TGF-β1, TβRI and TβRⅡ in wound tissue of 4 weeks could affect wound healing (P<0.05). The younger patients, the faster wound healing, and the higher expression of EPO, EPO receptor, TGF-β1, TβRI and TβRⅡ in wound tissue, the faster wound healing (P<0.05). At 0 week, the expression of EPO, EPO receptor, TGF-β1, TβRI and TβRⅡ in wound tissue of 2 groups were comparable (P>0.05). At 2nd week, EPO, EPO receptor, TGF-β1, TβRI and TβRⅡ had increased in both groups (P<0.05). At 4th weeks, EPO, EPO receptor, TGF-β1, TβRI and TβRⅡ had decreased in both groups (P<0.05). Compared with the slow healing group, the expression of EPO, EPO receptor, TGF-β1, TβRI and TβRⅡ had increased in the fast healing group (P<0.05). Conclusion:The expression of EPO, EPO receptor, TGF-β1, TβRI and TβRⅡin wounds of the third-degree burns limbs were significantly correlated with the healing time, the higher EPO, EPO receptor, TGF-β1, TβRI and TβRⅡ are the faster the wound healing.

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