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中华损伤与修复杂志(电子版) ›› 2019, Vol. 14 ›› Issue (01) : 34 -38. doi: 10.3877/cma.j.issn.1673-9450.2019.01.007

所属专题: 文献

论著

Ⅳ期压疮愈合过程中创面渗出液基质金属蛋白酶-9、基质金属蛋白酶抑制剂-1的表达水平变化的研究
王越1, 李贤2,(), 王瑶2, 高占红2, 赵伟2, 孙素娟2, 陈紫叶2, 张超2   
  1. 1. 067000 承德医学院
    2. 050000 石家庄,河北省人民医院护理部
  • 收稿日期:2018-12-02 出版日期:2019-02-01
  • 通信作者: 李贤
  • 基金资助:
    河北省医学科学研究重点课题(20160463); 河北省研究生创新资助项目(CXZZSS2018145)

Study on the changes in the expression levels of matrix metalloproteinase-9 and matrix metalloproteinase inhibitor-1 in wound exudate during wound healing of stage IV pressure ulcer

Yue Wang1, Xian Li2,(), Yao Wang2, Zhanhong Gao2, Wei Zhao2, Sujuan Sun2, Ziye Chen2, Chao Zhang2   

  1. 1. Chengde Medical University, Chengde 067000, China
    2. Department of Nursing, Hebei General Hospital, Shijiazhuang 050000, China
  • Received:2018-12-02 Published:2019-02-01
  • Corresponding author: Xian Li
  • About author:
    Corresponding author: Li Xian, Email:
引用本文:

王越, 李贤, 王瑶, 高占红, 赵伟, 孙素娟, 陈紫叶, 张超. Ⅳ期压疮愈合过程中创面渗出液基质金属蛋白酶-9、基质金属蛋白酶抑制剂-1的表达水平变化的研究[J]. 中华损伤与修复杂志(电子版), 2019, 14(01): 34-38.

Yue Wang, Xian Li, Yao Wang, Zhanhong Gao, Wei Zhao, Sujuan Sun, Ziye Chen, Chao Zhang. Study on the changes in the expression levels of matrix metalloproteinase-9 and matrix metalloproteinase inhibitor-1 in wound exudate during wound healing of stage IV pressure ulcer[J]. Chinese Journal of Injury Repair and Wound Healing(Electronic Edition), 2019, 14(01): 34-38.

目的

探讨Ⅳ期压疮愈合过程中创面渗出液中基质金属蛋白酶-9(MMP-9)、基质金属蛋白酶抑制剂-1(TIMP-1)的表达情况及其与压疮愈合的关系。

方法

选择2017年7月至2018年4月在河北省人民医院就诊的Ⅳ期压疮患者39例,创面共59处,根据接诊时与治疗第4周末压疮愈合评估表(PUSH)评分差值进行分组,差值>2分为愈合良好组(n=26),≤2分为愈合不良组(n=13)。按照统一方法评估、清洗及清创后,选择合适的治疗方案进行换药,追踪4周,采集接诊时、治疗第1周末、第2周末、第3周末、第4周末创面渗出液,酶联免疫吸附测定法检测2组创面渗出液中MMP-9、TIMP-1表达水平及MMP-9/TIMP-1比值的变化情况。数据比较采用t检验。

结果

接诊时及治疗第1周末2组MMP-9表达差异无统计学意义(t=1.262、1.944,P值均大于0.05),而在治疗第2周末、第3周末、第4周末愈合不良组MMP-9表达水平分别为(189.27±90.15) ng/L、(176.95±75.47) ng/L、(149.30±63.08) ng/L,显著高于愈合良好组[(114.97±70.06) ng/L、(93.75±55.15) ng/L、(71.62±41.66) ng/L],差异有统计学意义(t=2.835、3.921、4.608,P值均小于0.05);不同时间点愈合良好组与愈合不良组TIMP-1表达水平比较,差异均无统计学意义(t=0.346、0.292、0.047、0.395、0.999,P值均大于0.05);接诊时及治疗第1周末2组MMP-9/TIMP-1比值差异均无统计学意义(t=1.023、1.134, P值均大于0.05),而在治疗第2周末、第3周末、第4周末时愈合不良组MMP-9/TIMP-1比值分别为(38.42±9.25)、(33.74±9.58)、(29.53±8.04),显著高于愈合良好组的(30.04±10.67)、(25.35±10.18)、(21.54±9.29),差异均有统计学意义(t=2.411、2.473、2.642,P值均小于0.05)。

结论

创面渗出液中MMP-9表达水平及MMP-9/TIMP-1比值变化与压疮愈合有关,过高的MMP-9及MMP-9/TIMP-1不利于压疮的愈合。

Objective

To investigate the relationship between the expression level of matrix metalloproteinase-9 (MMP-9), matrix metalloproteinase inhibitor-1(TIMP-1) and the healing of pressure ulcer in the exudate of stage IV pressure ulcer.

Methods

A total of 39 patients (59 wounds) with stage IV pressure ulcers from July 2017 to April 2018 in Hebei General Hospital were selected.The patients were divided into 2 groups according to the difference between receiving and the fourth weekend pressure ulcer scale for healing (PUSH) score. The difference >2 points was a good healing group (n=26) and ≤2 points was a poor healing group(n=13). After evaluation, cleaning and debridement in accordance with the unified method, appropriate therapeutic regimen was selected to change dressings and track for four weeks. Collect the wound exudate at different time points: the time of diagnosis, the first weekend of treatment, the second weekend of treatment, the third weekend of treatment and the fourth weekend of treatment. The changes of MMP-9, TIMP-1 expression level and MMP-9 / TIMP-1 ratio in wound effusion of the two groups were detected by enzyme-linked immuno sorbent assay. Date were compared by t test.

Results

There was no significant difference in MMP-9 expression between the two groups at the time of diagnosis and the first weekend of treatment (t=1.262, 1.944, with P values above 0.05). At the second weekend, the third weekend, the fourth weekend of treatment, the expression level of MMP-9 in the poor healing group was (189.27±90.15) ng/L, (176.95±75.47) ng/L, (149.30±63.08) ng/L, which was significantly higher than that in the good healing group [(114.97±70.06) ng/L, (93.75±55.15) ng/L, (71.62±41.66) ng/L], the difference was statistically significant (t=2.835, 3.921, 4.608, with P values below 0.05). There was no statistically significant difference in TIMP-1 expression between the good healing group and the poor healing group at different time points (t=0.346, 0.292, 0.047, 0.395, 0.999, with P values below 0.05). There was no significant difference in the ratio of MMP-9 /TIMP-1 between the two groups at the time of diagnosis and the first weekend of treatment(t=1.023, 1.134, with P values above 0.05). At the second, third and fourth weekends of treatment, MMP-9 / TIMP-1 ratio in the poor healing group was (38.42±9.25), (33.74±9.58), (29.53±8.04), which was significantly higher than that in the good healing group [(30.04±10.67), (25.35±10.18), (21.54±9.29)], the difference was statistically significant (t=2.411, 2.473, 2.642, with P values below 0.05).

Conclusion

The changes of MMP-9 expression level and MMP-9/TIMP-1 ratio in wound exudate were related to the healing of pressure ulcer, while high level of expression of MMP-9 and MMP-9/TIMP-1 were not conducive to the healing of pressure ulcer.

表1 愈合良好组与愈合不良组Ⅳ期压疮患者一般资料比较
表2 不同时间点愈合良好组与愈合不良组MMP-9表达水平比较(±s,ng/L)
表3 不同时间点愈合良好组与愈合不良组TIMP-1表达水平比较(±s, ng/L)
表4 不同时间点愈合良好组与愈合不良组MMP-9/TIMP-1比较(±s)
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