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低分子量肝素对烧伤创面愈合的药理学调节作用。

Low molecular weight heparin-induced pharmacological modulation of burn wound healing.

作者信息

Ravikumar T, Shanmugasundaram N, Jayaraman V, Ramakrishnan K M, Babu M

机构信息

Biomaterials Division, Central Leather Research Institute, TICEL Biopark, Taramani, Chennai, Tamil Nadu, India.

出版信息

Ann Burns Fire Disasters. 2006 Sep 30;19(3):123-9.

Abstract

Low molecular weight heparin (LMWH) appears to be a promising solution for reducing inflammatory post-burn episodes and results in improved healing. The clinical examination presented here includes patients with burn wounds ranging from 20 to 35% total body surface area (TBSA) who were categorized into two groups, of which one received subcutaneous LMWH treatment (10,000 units/day) and the other acted as control. The process of healing was assessed through regular examination of clinical features such as regression of erythema and oedema, eschar formation, and rate of re-epithelialization. Various studies have demonstrated an increase in levels of serum IL-6 indicating the severity of the morbid condition. In the present investigation, LMWH-treated patients exhibited a faster decline in levels of serum IL-6 (within 12 days) than control. Infiltration of inflammatory cells at the local wound site was assessed through a histological analysis of tissue samples taken on various days during the healing process. The LMWH-treated groups exhibited an organized healing pattern with better remodelling in a shorter duration (28 days), while control patients took more than 28 days for complete healing. A slight correlation was observed with TBSA to the inflammatory process, which subsided in patients treated with LMWH, favourably modulating the events involved in the inflammatory process of burn wound healing.

摘要

低分子量肝素(LMWH)似乎是减少烧伤后炎症发作的一种有前景的解决方案,并能促进愈合。此处展示的临床检查包括全身表面积(TBSA)为20%至35%的烧伤患者,这些患者被分为两组,其中一组接受皮下LMWH治疗(10,000单位/天),另一组作为对照组。通过定期检查临床特征来评估愈合过程,如红斑和水肿的消退、焦痂形成以及再上皮化速率。各种研究表明血清IL - 6水平升高表明病情的严重程度。在本研究中,接受LMWH治疗的患者血清IL - 6水平下降速度更快(在12天内),比对照组更快。通过对愈合过程中不同时间采集的组织样本进行组织学分析,评估局部伤口部位炎症细胞的浸润情况。接受LMWH治疗的组表现出有组织的愈合模式,在较短时间(28天)内有更好的重塑,而对照组患者完全愈合需要超过28天。观察到TBSA与炎症过程有轻微相关性,在接受LMWH治疗的患者中炎症减轻,有利地调节了烧伤创面愈合炎症过程中涉及的事件。

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本文引用的文献

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Novel drug development opportunities for heparin.肝素的新型药物开发机遇。
Nat Rev Drug Discov. 2002 Feb;1(2):140-8. doi: 10.1038/nrd724.
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Heparin in the treatment of burns: a review.肝素在烧伤治疗中的应用综述
Burns. 2001 Jun;27(4):349-58. doi: 10.1016/s0305-4179(00)00130-3.

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