封闭负压引流对人慢性创面中基质金属蛋白酶的影响

目的：研究人慢性创面在经封闭负压引流（Vacuum-assisted-closure V.A.C)治疗前后，创面肉芽组织中基质金属蛋白酶（metalloproteinase,MMp)MMP1,MMP2,MMP13，以及金属蛋白酶组织抑制剂（tissue inhibitor of melalloproteinase,TIMP)TIMP-1,TIMP-2 mRNA的变化。方法：对9例慢性创面患者给予V.A.C治疗（－120mmHg压力），分别于治疗前和治疗后1，4，7天切取创面中央肉芽组织，提取总RNA，利用RT－PCR方法测定MMP－1，MMP－2，13和TIMP－1，TIKMP－2mRNA的表达情况，并对其定量结果进行统计学分析。结果；MMP－1，13mRNA在V.A.C治疗后表达下降，以MMP－13下降趋势尤为明显。MMP－2mRNA表达呈现波动，但总体为下降趋势，在V．A．C治疗前，检测不到TIMP－1，2mRNA的表达，应用V．A．C后，出现了两者的表达，而且随时间的延长，TIMKP－1，2mRNA的表达呈现明显的上升趋势。结论：V．A．C通过抑制MMP－1，2，13mRNA的表达，促进TIMP－1，2mRNA的表达，使更多的MMP与TIMP形成复合物进而抑制胶原和明胶的降解，促进慢性创面的愈合，同时也反向证明慢性创面形成过程中，MMP－1，2，13mRNA的表达增加以及TIMP－1，2，mRNA表达下降是重要因素。

Vaccum -Assisted -Closure (V. A. C) affect the expressions of metalloproteinases in chronic wound

Objective: To study the variations of MMP1, 2, 13and TIMP1, 2 mRNA in granulation tissues of human chronic wounds before and after treatment with V. A. C. Methods: Using RT - PCR, we determined the expressions of MMP -1, 2,13 and TIAAP -1, 2 mRNA in granulation tissues from 9 patients with chronic wounds before and 1, 4, 7days after treatment with V. A. C . Results: MMP -1, 13 mRNA took on an obvious tendency of decrease with the steepest variations in MMP -13. Although there were contradictory results in MMP -2mRNA, the decrease tendency was the same. There was no expression of TIMP -1, 2 mRNA before V. A. C. But TIMP -1, 2mRNA began to express after V. A. C as well as taking on obvious tendencies of increase with the time going. Conclusion: V. A. C could improve chronic wounds healing through depressing the expressions of MMP -1, 2,13 mRNA and promoting the expressions of TIMP -1, 2 mRNA therefore depressing the degradations of collagens and gelations. Also it can prove that high expressions of MMP-1,2,13 mRNA and lower expressions of TIMP-1, 2 mRNA are important factors during the formation of chronic wounds.