Cheng X, Zhan J H, Luo J H, Zheng G Y
Department of Burns, the First Affiliated Hospital of Nanchang University, Nanchang 330006, China.
Zhonghua Shao Shang Za Zhi. 2020 Apr 20;36(4):317-322. doi: 10.3760/cma.j.cn501120-20190125-00017.
To explore the effect of alprostadil in early wound healing of rats with deep partial-thickness scald. Ninety specific pathogen free healthy Sprague-Dawley rats (half males and half females) were divided into sham scald group, simple scald group, and alprostadil group using the random number table with 30 rats in each group. Rats in sham scald group were sham injured, and rats in the other 2 groups were inflicted with deep partial-thickness scald of 30% total body surface area on the back. Immediately after scald, rats in the 3 groups received anti-shock treatment. Two hours post scald, rats in sham scald group and simple scald group were injected intraperitoneally with 1 mL normal saline, and rats in alprostadil group were injected intraperitoneally with 1 mL alprostadil injection, once a day and continued for 14 days. On post scald day (PSD) 3, 7, and 14, 10 rats in each group were collected for observing the general wound conditions and the wound healing rates of rats in 2 scald groups were calculated, abdominal aortic blood of 2 mL from each rat were collected to detect serum thromboxane B2 by enzyme-linked immunosorbent assay, and wound tissue on the back was collected to examine pathomorphological change by hematoxylin-eosin staining and to detect wound microvessel density (MVD) by immunohistochemical staining. Data were statistically analyzed with analysis of variance of factorial design, test, Kruskal-Wallis test, Mann-Whitney test, and Bonferroni correction. (1) There was no scald wound in rats in sham scald group. On PSD 3, wounds of rats in simple scald group and alprostadil group formed dry eschar. On PSD 7 and 14, wound areas of rats in alprostadil group were significantly smaller than those of rats in simple scald group, and with less exudation. (2) On PSD 3, the wound healing rates of rats in simple scald group and alprostadil group were similar (=1.167, >0.05). On PSD 7 and 14, the wound healing rates of rats in alprostadil group were significantly higher than those in simple scald group (=8.657, 33.050, <0.01). (3) On PSD 3, 7, and 14, the levels of serum thromboxane B2 of rats in simple scald group and alprostadil group were (541±22), (607±47), (688±21), (326±25), (271±21), (135±27) pg/mL, significantly higher than (17±6), (16±4), (16±4) pg/mL of rats in sham scald group (=72.977, 39.685, 102.076, 37.033, 37.253, 13.845, <0.01). On PSD 3, 7, and 14, the levels of serum thromboxane B2 of rats in alprostadil group were significantly lower than those in simple scald group (=20.637, 20.651, 51.680, <0.01). (4) Normal epidermis and dermis were seen in rats in sham scald group. On PSD 3, a large number of necrotic tissue and inflammatory cells infiltration were seen in wounds of rats in simple scald group, while a little new epithelium formation and some inflammatory cells infiltration were seen in wounds of rats in alprostadil group. On PSD 7 and 14, the new epithelium of rats in alprostadil group was significantly thicker than that in simple scald group, and epidermis formed gradually in alprostadil group. (5) On PSD 3, 7, and 14, the wound MVD of rats in simple scald group and alprostadil group were significantly higher than those in sham scald group (=-3.780, -3.781, -3.780, -3.780, -3.781, -3.780, <0.01). On PSD 3, the wound MVD of rats in simple scald group and alprostadil group were similar (=-1.965, >0.05). On PSD 7 and 14, the wound MVD of rats in alprostadil group were significantly higher than those in simple scald group (=-3.780, -3.780, <0.01). The early intervention with alprostadil can significantly improve microcirculation of deep partial-thickness scald wound, reduce inflammatory cell infiltration, promote the formation of new blood vessels, thus promoting wound healing.
探讨前列地尔对大鼠深Ⅱ度烫伤早期创面愈合的影响。将90只无特定病原体的健康Sprague-Dawley大鼠(雌雄各半)采用随机数字表法分为假烫伤组、单纯烫伤组和前列地尔组,每组30只。假烫伤组大鼠行假损伤,另2组大鼠背部造成30%体表面积的深Ⅱ度烫伤。烫伤后即刻,3组大鼠均进行抗休克处理。烫伤后2小时,假烫伤组和单纯烫伤组大鼠腹腔注射1 mL生理盐水,前列地尔组大鼠腹腔注射1 mL前列地尔注射液,每日1次,连续14天。在烫伤后第3、7和14天,每组各取10只大鼠,观察创面一般情况,计算2个烫伤组大鼠的创面愈合率,每只大鼠采集2 mL腹主动脉血,采用酶联免疫吸附法检测血清血栓素B2,取背部创面组织,采用苏木精-伊红染色观察病理形态学变化,采用免疫组织化学染色检测创面微血管密度(MVD)。数据采用析因设计方差分析、t检验、Kruskal-Wallis检验、Mann-Whitney检验及Bonferroni校正进行统计学分析。(1)假烫伤组大鼠无烫伤创面。烫伤后第3天,单纯烫伤组和前列地尔组大鼠创面形成干痂。烫伤后第7天和14天,前列地尔组大鼠创面面积明显小于单纯烫伤组,且渗出较少。(2)烫伤后第3天,单纯烫伤组和前列地尔组大鼠创面愈合率相近(F=1.167,P>0.05)。烫伤后第7天和14天,前列地尔组大鼠创面愈合率明显高于单纯烫伤组(F=8.657、33.050,P<0.01)。(3)烫伤后第3、7和14天,单纯烫伤组和前列地尔组大鼠血清血栓素B2水平分别为(541±22)、(607±47)、(688±21)、(326±25)、(271±21)、(135±27)pg/mL,明显高于假烫伤组的(17±6)、(16±4)、(16±4)pg/mL(F=72.977、39.685、102.076、37.033、37.253、13.845,P<0.01)。烫伤后第3、7和14天,前列地尔组大鼠血清血栓素B2水平明显低于单纯烫伤组(F=20.637、20.651、51.680,P<0.01)。(4)假烫伤组大鼠可见正常表皮和真皮。烫伤后第3天,单纯烫伤组大鼠创面可见大量坏死组织及炎性细胞浸润,前列地尔组大鼠创面可见少量新上皮形成及少量炎性细胞浸润。烫伤后第7天和14天,前列地尔组大鼠新上皮明显厚于单纯烫伤组,且前列地尔组逐渐形成表皮。(5)烫伤后第3、7和14天,单纯烫伤组和前列地尔组大鼠创面MVD明显高于假烫伤组(t=-3.780、-3.781、-3.780、-3.780、-3.781、-3.780,P<0.01)。烫伤后第3天,单纯烫伤组和前列地尔组大鼠创面MVD相近(t=-1.965,P>0.05)。烫伤后第7天和14天,前列地尔组大鼠创面MVD明显高于单纯烫伤组(t=-3.780、-3.780,P<0.01)。前列地尔早期干预可明显改善深Ⅱ度烫伤创面的微循环,减少炎性细胞浸润,促进新生血管形成,从而促进创面愈合。