糖尿病足溃疡创面感染患者MMP-2、TIMP-2、Smad3蛋白表达状况及其诊断价值分析

目的探究糖尿病足溃疡创面感染患者的基质金属蛋白酶2(MMP-2)、基质金属蛋白酶2抑制因子(TIMP-2)、Smad3蛋白的表达状况及其诊断价值。方法回顾性分析达州市中心医院于2017年3月至2018年9月收治的45例糖尿病足溃疡患者资料。将伴有溃疡创面感染的25例糖尿病足者作为观察组,其中单一细菌感染16例,混合细菌感染9例;Ⅱ级溃疡11例,Ⅲ级溃疡14例。其余20例未伴有溃疡创面感染的糖尿病足患者作为对照组。对比两组患者的MMP-2、TIMP-2、Smad3蛋白的表达状况,同时对观察组中不同感染类型、不同溃疡类型患者的MMP-2、TIMP-2、Smad3蛋白的表达状况进行比较。结果观察组患者溃疡创面的MMP-2、MMP-2/TIMP-2及Smad3水平均明显高于对照组,TIMP-2水平显著低于对照组差异有统计学意义(P <0.05)。不同感染类型和不同溃疡类型患者的TIMP-2水平比较无显著差异(P>0.05),混合感染患者溃疡创面的MMP-2、MMP-2/TIMP-2和Smad3水平均明显高于单一感染患者;Ⅲ级溃疡患者的MMP-2、MMP-2/TIMP-2和Smad3水平均明显高于Ⅱ级溃疡,差异有统计学意义(P <0.05)。结论糖尿病足溃疡创面感染患者的感染种类以及溃疡程度与MMP-2、TIMP2失衡以及Smad3蛋白异常表达明显相关。观察MMP-2、TIMP-2、Smad3蛋白水平变化对于糖尿病足溃疡创面感染患者的病情评估及其预后判断具有重要价值。

The expression of MMP-2,TIMP-2 and Smad3 in diabetic foot ulcer patients with wound infection and its diagnostic value

Objective To research the expression of matrix metalloproteinase-2(MMP-2) and tissue inhibitor of metalloproteinase-2(TIMP-2) and Smad3 in diabetic foot ulcer patients with wound infection and its diagnostic value.Methods 45 patients with diabetic foot ulcer admitted to our hospital from March 2017 to September 2018 were taken as the research object,25 patients with diabetic foot ulcer wound infection were taken as the observation group,there were 16 cases of single bacterial infection and 9 cases of mixed bacterial infection,and there were 11 cases of grade Ⅱ ulcer and 14 cases of grade Ⅲ ulcer.The remaining 20 patients with diabetic foot without ulcer wound infection were taken as the control group.The expression of MMP-2,TIMP-2 and Smad3 proteins in two groups were compared,and the expression of MMP-2,TIMP-2 and Smad3 proteins in different types of infection and ulcer in observation group were compared.Results The levels of MMP-2,MMP-2/TIMP-2 and Smad3 in ulcer wounds in the observation group were significantly higher than those in the control group,and the levels of TIMP-2 were significantly lower than those in the control group,with statistical significance(P <0.05).There were no significant differences in TIMP-2 levels between patients with different types of infection and ulcer(P> 0.05).The levels of MMP-2,MMP-21 TIMP-2 and Smad3 in ulcer wounds of patients with mixed infection were significantly higher than those of patients with single infection,the levels of MMP-2,MMP-2/TIMP-2 and Smad3 in patients with grade Ⅲ ulcer were significantly higher than those in patients with grade Ⅱ ulcer,the differences were statisti?cally significant(P <0.05).Conclusion The types and degree of infection in diabetic foot ulcer patients are significantly correlated with the imbalance of MMP-2,TIMP2 and the abnormal expression of Smad3 protein.Observing the changes of MMP-2,TIMP-2 and Smad3 protein levels is of great value for the evaluation of the disease and prognosis of diabetic foot ulcer patients with wound infection.