摘要
目的观察微粒皮种植治疗糖尿病溃疡过程中,溃疡肉芽组织中转化生长因子-β_1(TGF-β_1)、基质金属蛋白酶(MMP-1)、基质金属蛋白酶抑制因子(TIMP-1)的动态变化。方法 25例糖尿病溃疡患者进行微粒皮种植治疗,治疗前和治疗第7天、第14天分别采集创面肉芽组织。酶联免疫法检测肉芽组织中TGF-β_1、MMP-1、TIMP-1浓度,观察溃疡愈合情况。结果微粒皮种植治疗后溃疡面积渐缩小,治疗后第14天创面较治疗前明显缩小(P<0.05);治疗后肉芽组织中TGF-β_1蛋白水平在治疗后第7天明显升高(P<0.05),第14天较第7天降低(P<0.05),但仍较治疗前升高(P<0.05)。MMP-1蛋白水平在治疗后第7天有所升高(P>0.05),第14天时明显下降,低于治疗前与治疗第7天(P<0.05)。TIMP-1治疗后第7天升高(P<0.05),治疗后第14天比第7天有所降低(P>0.05),但仍比治疗前升高(P<0.05)。MMP-1/TIMP-1呈逐渐下降趋势,治疗第14天较治疗第7天及治疗前均明显下降(P<0.05)。肉芽组织中的MMP-1/TIMP-1比值与溃疡面积大小呈正相关,r=0.347,P<0.05。结论微粒皮种植治疗可动态调节及平衡糖尿病溃疡肉芽组织中TGF-β_1、MMP-1、TIMP-1浓度,肉芽组织MMP-1/TIMP-1比值可能是影响糖尿病皮肤溃疡愈合的相关因素。
Objective To investigate the dynamic changes of TGF-β_1,matrix metalloproteinase-1(MMP-1)and tissue inhibitor of matrix metalloprotease-l(TIMP)in granulation tissue of ulcers during the treatment of diabetic ulcers by microskin grafting.Methods 25 cases of diabetic ulcers were treated with micro skin grafting.Wound granulation tissue was collected before and after treatment.Enzyme-linked immunosorbent assay was used to detect the concentration of TGF-β_1,MMP-1 and TIMP-1 in granulation tissue at 0 day,7 days,14 days respectively in patients.The areas of ulcers were observed and measured.Results After microskin grafting treatment,the ulcer area decreased gradually,and the wound area decreased significantly on the 14th day after treatment compared with area before the treatment(P<0.05).After treatment,the protein level of TGF-β_1 in granulation tissue was significantly increased on the 7th day(P<0.05),and decreased on the 14th day compared with the 7th day,but still increased compared with the pre-treatment(both P<0.05).The level of MMP-1 protein in granulation tissue increased on the 7th day after treatment(P>0.05),and decreased significantly on the 14th day(P<0.05)compared with that before and after treatment on the 7th day).The level of TIMP-1 increased on the 7th day after treatment(P<0.05),and the level on the 14th day was higher than that before treatment(P<0.05),which was lower than that on the 7th day of treatment(P>0.05).MMP-1/TIMP-1 showed a gradually decreasing trend,and significantly decreased on the 14th day after treatment compared with the 7th day after treatment and before treatment(both P<0.05).The ratio of MMP-1/TIMP-1 in granulation tissue was positively correlated with the size of ulceration area(r=0.347,P<0.05).Conclusion Microskin grafting therapy can dynamically regulate and balance the concentrations of TGF-β_1,MMP-1 and TIMP-1 in the granulation tissue of diabetic ulcer.The ratio of MMP-1/TIMP-1 in granulation tissue may be arelevant factor influencing the healing of diabetic ulcers.
作者
戚世玲
方铭恒
谢振谋
底大可
薛汝增
何仁亮
QI Shi-ling;FANG Ming-heng;XIE Zhen-mou;DI Da-ke;XUE Ru-zeng;HE Ren-liang(The Fifth Affiliated Hospital of Guangzhou Medical University,Guangzhou,Guangdong 510700,China;Dermatology Hospital of Southern Medical University,Guangzhou,Guangdong 510091,China)
出处
《皮肤病与性病》
2020年第6期798-800,共3页
Dermatology and Venereology
基金
广东省医学科学技术研究基金项目(A2017495)。
