人脐带间充质干细胞分泌因子脂质体治疗黑素细胞痣激光治疗后皮肤损伤疗效观察

来源:用户上传      作者:袁佩雯 王培森 侯秀英 李勤雨 李丽 张宝林 聂君毅 彭艳

　　[摘要]目的：探讨人脐带间充质干细胞分泌因子脂质体用于黑素细胞痣激光治疗后皮肤损伤的疗效。方法：将56例激光治疗后的黑素细胞痣患者随机分为对照组和治疗组各28例，对照组术后用空白脂质体涂抹治疗，治疗组术后用人脐带间充质干细胞分泌因子脂质体涂抹治疗，比较两组患者的损伤反应、伤口愈合时间、皮肤镜下愈合情况及总有效率。结果：术后不同时间点两组损伤反应评分呈递减趋势，术后2 d及术后4 d治疗组损伤反应弱于对照组（P<0.05），治疗组伤口愈合时间明显短于对照组（P<0.05），皮肤镜下愈合情况优于对照组，总有效率（100.00%）显著高于对照组（78.57%，P<0.05）。结论：人脐带间充质干细胞分泌因子脂质体用于黑素细胞痣激光治疗后皮肤损伤有较好疗效，值得临床推广应用。
　　[关键词]人脐带;间充质干细胞;脂质体;创面修复;激光;黑素细胞痣
　　[中图分类号]R739.5 [文献标志码]A [文章编号]1008-6455（2022）05-0010-04
　　Effect of Human Umbilical Cord Mesenchymal Stem Cell Secretory Factor Liposome on Skin Damage after Laser Treatment of Melanocytic Nevus
　　YUAN Peiwen1，WANG Peisen1，HOU Xiuying2，LI Qinyu2，LI Li2，ZHANG Baolin2，NIE Junyi1，PENG Yan1
　　（1.The First Clinical Medical College of Shanxi Medical University，Taiyuan 030001，Shanxi，China;2.The First Hospital of Shanxi Medical University，Taiyuan 030001，Shanxi，China）
　　Abstract： Objective To observe the therapeutic effect of human umbilical cord mesenchymal stem cell secretory factor liposome on skin injury of melanocyte nevus after laser treatment. Methods 56 cases of melanocyte nevus after laser treatment of the patients were randomly divided into control group and treatment group. The control group was treated with blank liposome and the treatment group was treated with human umbilical cord mesenchymal stem cell secretory factor liposome. The injury response， wound healing time， cutaneous healing and total effective rate were compared between the two groups. Results The injury response scores of the two groups at different postoperative time points showed a decreasing trend， and the injury response of the treatment group at all other time points except 0 d after surgery was weaker than that of the control group （P<0.05）， and the wound healing time was significantly shorter than that of the control group （P<0.05）， the healing condition under dermoscopy was better than that of the control group， and the total effective rate （100.00%） was higher than that of the control group （78.57%， P<0.05）. Conclusion Human umbilical cord mesenchymal stem cell secretory factor liposome has a significant effect on skin injury after laser treatment of melanocyte nevus. It is worthy of clinical application.
　　Key words： human umbilical; cord mesenchymal stem cell; liposome; wound repair; laser; melanocytic nevus
　　黑素胞痣（Melanocytic nevus），是最常见的一种良性皮肤肿瘤，由表皮、真皮内黑素细胞数目增多引起[1]。对于较小的黑素细胞痣来说，二氧化碳激光可在对病变处切割和灼烧的过程中瞬间完成气化作用，以达到治疗目的[2]。但不足的是，激光治疗后，短时间内会对患者皮肤造成损伤，若处理不当则极易形成瘢痕及色素沉着，为此临床医生采用了多种方法解决激光后皮肤损伤问题。间充质干细胞（Mesenchymal stem cells， MSCs）是一类具有强大自我更新和分化能力的多能干细胞，在组织工程和再生医学中发挥着重要作用[3]。人脐带间充质干细胞（Human umbilical cord mesenchymal stem cells，hUC-MSCs）易于获取，其分泌因子中含有血管内皮生长因子、白细胞介素8和单核细胞趋化蛋白1等细胞因子可诱导新生血管的形成、加速角质形成细胞迁移及肉芽组织形成，促进创面愈合。脂质体作为一种特殊性质的磷脂，与皮肤角质层具有相似的脂质双分子层结构[4-5]，将hUC-MSCs分泌因子包裹在脂质体中可以有效促进分泌因子的透皮吸收，加快创面愈合。为此，本课题组将先前制备的人脐带间充质干细胞分泌因子脂质体[6]用于黑素细胞痣激光治疗后的皮损创面，探究其对损伤反应、愈合时间、色素沉着及瘢痕形成的影响，现报道如下。

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