摘要
目的 观察间充质干细胞外泌体在肾移植术后口腔溃疡防治中的效果.方法 选取 2021 年 10 月—2022 年4 月收治的100 例肾移植术后患者,统计口腔溃疡发生情况,将发生口腔溃疡患者根据干预方法不同分为观察组20 例和对照组20 例.对照组给予常规生理盐水口腔护理,观察组经常规护理后给予间充质干细胞外泌体喷雾剂治疗,连续干预7d.比较2 组治疗效果、口腔溃疡及恢复情况(进食恢复时间、疼痛消失时间、溃疡愈合时间),比较治疗前及治疗3、7d后2 组口腔pH值、唾液免疫球蛋白[分泌型免疫球蛋白A(sIgA)、溶菌酶(Lys)、免疫球蛋白G(IgG)]、血清炎性因子[白细胞介素-6(IL-6)、转化生长因子-β(TGF-β)、前列腺素 E2(PGE2)、肿瘤坏死因子-α(TNF-α)]、口腔溃疡疼痛视觉模拟评分法(VAS)评分、口腔评估指南(OAG)评分、口腔健康影响程度量表(OHIP-14)评分.结果 100 例肾移植术后患者中有 40 例发生口腔溃疡,观察组总有效率为 95.00%(19/20)高于对照组的65.00%(13/20)(P<0.05);观察组进食恢复时间、疼痛消失时间、溃疡愈合时间均短于对照组(P<0.05,P<0.01);治疗3、7d后观察组口腔pH值、唾液sIgA水平高于对照组,唾液Lys、IgG水平低于对照组(P<0.05,P<0.01);治疗3、7d后观察组血清IL-6、TGF-β、PGE2、TNF-α水平及OAG评分、VAS评分、OHIP-14 评分均低于对照组(P<0.05,P<0.01).结论 肾移植后口腔溃疡发生率较高,间充质干细胞外泌体应用于肾移植术后口腔溃疡患者治疗效果较好,可缩短疼痛、溃疡愈合时间,缓解炎症反应,改善患者口腔健康状态.
Abstract
Objective To observe the effectiveness of mesenchymal stem cell-derived extracellular vesicles(MSC-EVs)in the prevention and treatment of oral ulcers after kidney transplantation.Methods A total of 100 patients ad-mitted from October 2021 to April 2022 and underwent kidney transplantation were selected to analyze the incidence of oral ul-cers.Patients with oral ulcers were divided into the observation group(n =20)and the control group(n =20)based on dif-ferent intervention methods.The control group was given normal saline for oral care,and the observation group was given mes-enchymal stem cell exocrine spray after regular care for 7 consecutive days.The treatment effectiveness,oral ulcer and recov-ery status of the two groups(recovery time of food intake,pain disappearance time,ulcer healing time)were compared be-tween the two groups.The oral pH value,saliva immunoglobulin[secretory immunoglobulin A(sIgA),lysozyme(Lys),im-munoglobulin G(IgG)],serum inflammatory factors[interleukin-6(IL-6),transforming growth factor-β(TGF-β)],pros-taglandin E2(PGE2),tumor necrosis factor-α(TNF-α)],oral ulcer Visual Analog Scale(VAS)pain score,Oral Assess-ment Guidelines(OAG)score,and Oral Health Profile-14(OHIP-14)Scale score of the two groups before treatment and at 3 and 7 days after treatment were compared.Results Among the 100 patients who underwent kidney transplantation,40 de-veloped oral ulcers.The total effective rate of the observation group was 95.00%(19/20),which was higher than that[65.00%(13/20)]of the control group(P<0.05).The observation group had shorter recovery time of food intake,pain disappearance time,and ulcer healing time than the control group(P<0.05,P<0.01).At 3 and 7 days after treatment,the pH value and saliva sIgA levels in the observation group were higher than those in the control group,while the saliva Lys and IgG levels were lower than those in the control group(P<0.05,P<0.01).The levels of serum IL-6,TGF-β,PGE2,and TNF-α in the observation group were lower than those of the control group at 3 and 7 days after treatment(P<0.01).At 3 and 7 days after treatment,the OAG score,VAS score,and OHIP-14 score of the saliva sIgA group were lower than those of the control group(P<0.05,P<0.01).Conclusion The incidence of oral ulcers after kidney transplantation is relatively high,and the application of MSC-EVs is effective in the treatment of oral ulcers after kidney transplantation.It can shorten the duration of pain and ulcer healing time,alleviate inflammatory reactions,and improve the oral health status of patients.
维普
万方数据