【摘要】 目的:本研究旨在构建失禁性皮炎(incontinence-associated dermatitis, IAD)大鼠模型并评估不同护理措施的治疗效果。方法:将54只SD大鼠随机分为9组:对照组、胰蛋白酶浸渍IAD模型组、模型+氧化锌组、模型+无痛皮肤保护膜组、模型+硅酮敷料组、联合模型组(人工尿液联合胰蛋白酶)、联合模型+氧化锌组、联合模型+无痛皮肤保护膜组和联合模型+硅酮敷料组,每组6只。每天观察IAD的严重程度。4 d后,H&E染色评估皮肤组织的病理改变;免疫组化检测MHC-Ⅱ的表达;蛋白质印迹分析检测肿瘤坏死因子-κB(NF-κB)p65、p-NF-κB p65、STAT1、p-STAT1蛋白质的表达情况。结果:IAD模型组的皮炎严重程度均高于对照组。与模型组相比,经氧化锌、无痛皮肤保护膜或硅酮敷料治疗4 d后,皮炎显著缓解(P<0.05)且pH值明显降低。H&E染色结果显示,模型组的大鼠皮肤组织结构严重破坏,创面无表皮覆盖,可见大量的炎性细胞浸润。经治疗后,皮肤组织明显恢复,其中硅酮敷料组恢复效果最好。与对照组相比,模型组的大鼠皮肤组织中MHC-Ⅱ、NF-κB p65、p-NF-κB p65、STAT1和p-STAT1的表达显著升高。经治疗后,以上蛋白质的表达显著降低,差异均有统计学意义(P<0.05),其中硅酮敷料组降低最明显。结论:氧化锌、无痛皮肤保护膜和硅酮敷料均能有效减轻IAD的症状,但硅酮敷料的治疗效果最好。更多还原

【Abstract】 Objective:To construct a rat model of incontinence-associated dermatitis(IAD) and evaluate the treatment effects of different nursing measures.Methods:A total of 54 Sprague-Dawley(SD) rats were randomly divided into 9 groups: control group, trypsin-impregnated IAD model group, model + zinc oxide group, model + painless skin protective film group, model + silicone dressing group, combined model group(artificial urine combined with trypsin),combined model + zinc oxide group, combined model + painless skin protective film group, and combined model + silicone dressing group, 6 cases in each.The severity of IAD every day was observed.Four days later, H&E staining was used to evaluate the pathological changes of skin tissue; immunohistochemistry to detect the expression of MHC-Ⅱ;western blot analysis to detect the expression of NF-κB p65,p-NF-κB p65,STAT1,and p-STAT1 protein.Results:The severity of dermatitis in the IAD model group was higher than that in the control group.Compared with the model group, after 4 days of treatment with zinc oxide, painless skin protective film, and silicone dressing, the dermatitis was significantly relieved(P<0.05),and the pH value was significantly reduced.H&E staining results showed that the skin tissue structure of rats in the model group was severely damaged, the epidermis did not cover the wounds, and many inflammatory cell infiltrations were seen.After the treatment, the skin tissue recovered significantly, and the silicone dressing group had the best recovery effect.Compared with the control group, the expression of MHC-Ⅱ,NF-κB p65,p-NF-κB p65,STAT1,and p-STAT1 in the skin tissue of the model group increased significantly.After treatment, the expression of the above proteins was significantly reduced, and the difference was statistically significant(P<0.05).Among them, the reduction in the silicone dressing group was the most obvious.Conclusions:Zinc oxide, painless skin protective film, and silicone dressing could effectively alleviate the symptoms of IAD,and silicone dressing had the best effect.更多还原