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目的:研究外用重组人粒细胞_巨噬细胞集落刺激因子( rhGM_CSF)和纳米银敷料外用,对深域度烫伤创面组织愈合及血管化的影响。方法用Wistar大鼠建立深域度烫伤模型,分为A、B、C 组。 A组( n=30):凡士林纱布覆盖,B组(n=30):纳米银敷料覆盖,C组(n=30):rhGM_CSF涂抹创面。伤后第1,4,7,10,14,21天,观察创面病理学改变,按照酶联免疫吸附法测定血清中血管内皮生长因子( VEGF)水平,采用实时_聚合酶链反应( RT_PCR)方法,检测创面愈合过程中缺血坏死因子_1α( HIF_1α) mRNA表达的变化。结果病理学改变:A、B、C组均在第10天出现明显的血管化;创面愈合率:C组>B组>A组,第14天、第21天时,组间差异有统计学意义(P0.05),第4,7,10,14天3组间及第21天A组和C组之间差异有统计学意义(P<0.05)。 HIF_1αmRNA相对表达量:A组第14天达峰值,B组、C组逐渐增大,第10天达峰值,随后下降,且C组下降幅度最明显,第1天A组与B组、C组之间差异有统计学意义(P0.05),第7天A组与C组之间及第10,14,21天各组间差异均有统计学意义(P<0.05)。结论 rhGM_CSF和纳米银外用,促进深域度烫伤创面愈合过程中血管化的形成,并且rhGM_CSF血管化程度优于纳米银。“,”Objective To obserVe the effect of recombinant human granulocyte∕macroPhage colony stimulating factor ( rhGM_CSF) and nano_silVer as treatment for skin with deeP II degree burn. Methods DeeP II degree burn Wistar rat model was established. The rats were randomly diVided into three grouPs,Petrolatum treatment grouP (grouP A,n=30),nano_silVer treatment grouP (grouP B,n=30),and rhGM_CSF treatment grouP (grouP C,n=30). The Pathological changes of wound of the three grouPs were obserVed 1,4,7,10,14 and 21 days after the treatment. The concentration of VEGF in serums was measured with ELISA. The leVels of HIF_1α mRNA exPression were detected by RT_PCR. Results On day 10, neoVascularization deVeloPed in grouPs A, B and C. Healing rate of the wound was the highest in grouP C, lowest in grouP A, with significant differences among the three grouPs on day 14 and day 21 (P<0. 05). VEGF leVel Peaked on day 14 in grouP A,and on day 10 in grouPs B and C. There were significant differences in VEGF leVel on day 1 between grouP A and grouPs B,C,on day 7 between grouP A and grouP C,on day 10,14 and 21 among the three grouPs (P<0. 05),but no significant differences on day 4 among the three grouPs. Conclusion rhGM_CSF and nano_silVer treatment can accelerate neoVascularization of wound,and rhGM_CSF is better than nano_silVer.