胰岛素局部使用对糖尿病Ⅱ度烧伤患者创面愈合、创面微循环及ERK/JNK信号通路的影响OA
Effects of Local Use of Insulin on Wound Healing,Wound Microcirculation and ERK/JNK Signaling Pathway in Patients with Diabetic Second-degree Burn Wounds
目的:探讨胰岛素局部使用对糖尿病烧伤不同深度创面患者创面愈合、创面微循环及ERK/JNK信号通路的影响.方法:选取2022年4月-2025年4月运城市中心医院收治的197例糖尿病Ⅱ度烧伤患者,随机数字表法分为两组,常规组(99例)给予常规创面治疗,改良组(98例)在常规组基础上给予胰岛素局部使用.比较两组创面愈合率、创面微循环血液灌注量(Perfusion Unit,PU)、调节激酶(ERK)/末端激酶(JNK)信号通路、感染情况,并分析胰岛素局部使用后创面愈合的影响因素.结果:改良组治疗2周、3周后创面愈合率及累计愈合率显著高于常规组(P＜0.05);改良组治疗2周、3周、4周后创面微循环PU值显著高于常规组(P＜0.05);改良组治疗2周、3周、4周后p-JNK蛋白、p-ERK1/2蛋白、JNK mRNA、ERK1/2 mRNA显著低于常规组(P＜0.05);改良组创面感染发生率为0.00%,低于常规组的6.06%(P＜0.05);多因素Logistic回归分析显示,创面深度(深Ⅱ度烧伤)、糖化血红蛋白(HbA1c)升高是胰岛素局部使用后创面未愈合的独立危险因素(P＜0.05).结论:胰岛素局部使用可显著提高糖尿病烧伤患者早期愈合率、降低感染率,其作用可能与调控ERK/JNK信号通路表达、改善创面PU有关,且创面深度、HbA1c升高是胰岛素局部使用后创面未愈合的独立影响危险因素.
Objective To investigate the effects of local use of insulin on wound healing,wound microcirculation and ERK/JNK signaling pathway in patients with diabetic burn wounds at different depths.Methods A total of 197 patients with diabetic burns admitted to Yuncheng Central Hospital from April 2022 to April 2025 were selected and randomly divided into two groups.The conventional group(99 cases)was given conventional treatment,and the modified group(98 cases)was given local use of insulin on the basis of the conventional group.The wound healing rate,wound microcirculation blood perfusion(PU),extracellular signal-regulated kinase regulatory kinase(ERK)/c-Jun N-terminal kinase(JNK)signaling pathway and infection were compared between the two groups,and the influencing factors of wound healing after local use of insulin were analyzed.Results After 2 weeks and 3 weeks of treatment,the wound healing rate and cumulative healing rate in the modified group were significantly higher than those in the conventional group,and the differences were statistically significant(P＜0.05).The PU value of wound microcirculation in the modified group was significantly higher than that in the conventional group after 2 weeks,3 weeks and 4 weeks of treatment(P＜0.05).After 2 weeks,3 weeks and 4 weeks of treatment,the p-JNK protein,p-ERK1/2 protein,JNK mRNA and ERK1/2 mRNA in the modified group were significantly lower than those in the conventional group(P＜0.05).The incidence of wound infection in the modified group was 0.00%,which was lower than 6.06% in the conventional group(P＜0.05).Multivariate Logistic regression analysis showed that wound depth(deep seconddegree burn)and elevated glycated hemoglobin(HbA1c)were independent risk factors for non-healing wounds after topical insulin application(P＜0.05).Conclusion Topical insulin application can significantly improve the early stage wound healing rate and reduce the infection rate in diabetic patients with burns.Its effect may be related to regulating the expression of the ERK/JNK signaling pathway and improving wound PU.Wound depth and elevated HbA1c are independent risk factors for nonhealing wounds after topical insulin application.
张晓宁;于洪亮
山西省运城市中心医院烧伤科 山西 运城 044000山西省运城市中心医院烧伤科 山西 运城 044000
医药卫生
胰岛素烧伤糖尿病创面愈合ERK/JNK信号通路
insulinburnsdiabeteswound healingERK/JNK signaling pathway
《中国美容医学》 2026 (10)
19-24,6
山西省卫生健康委科研课题(编号:2024037)
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