医用胶原蛋白海绵外敷糖尿病足溃疡创面Ⅰ、Ⅲ型胶原蛋白和基质金属蛋白酶2,9的变化
Chinese Journal of Tissue Engineering Research（2022）
Abstract
背景:胶原蛋白已被广泛应用于口腔、血管、神经、骨及软骨组织等领域中,但胶原蛋白海绵在糖尿病足溃疡伤口的应用鲜有研究.目的:分析医用胶原蛋白海绵对糖尿病足溃疡伤口肉芽组织Ⅰ、Ⅲ型胶原蛋白及基质金属蛋白酶2、9表达的影响.方法:选择2019年1-12月天津医科大学代谢病医院足病科收治的46例糖尿病足溃疡患者,其中男25例,女21例,类随机法分2组治疗,对照组换药清创,实验组在对照组治疗的基础上创面填充胶原蛋白海绵.治疗前及治疗后第3,7,14天记录创面面积,计算创面愈合率;同时取创面肉芽组织,免疫组织化学染色观察基质金属蛋白酶2、基质金属蛋白酶9的表达情况,Western blot检测分析Ⅰ、Ⅲ型胶原蛋白表达情况.研究已通过天津医科大学朱宪彝纪念医院伦理委员会批准.结果 与结论:①随着治疗时间的延长,两组创面愈合率增加,试验组治疗后3,7,14 d的创面愈合率高于对照组(P<0.05);②随着治疗时间的延长,两组创面肉芽组织中的基质金属蛋白酶2、基质金属蛋白酶9沉积减少,实验组治疗后各时间点的基质金属蛋白酶2、9表达少于对照组(P<0.05);③随着治疗时间的延长,两组创面肉芽组织中的Ⅰ、Ⅲ型胶原蛋白表达增加,实验组治疗后各时间点的Ⅰ、Ⅲ型胶原蛋白表达表达高于对照组(P<0.05);④结果表明,医用胶原蛋白海绵可减少创面组织中基质金属蛋白酶2/9的表达,有助于Ⅰ、Ⅲ型胶原蛋白的合成,提高创面愈合率.
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