粒细胞-巨噬细胞集落刺激因子对烧伤后残余创面基质金属蛋白酶及其组织抑制剂的影响  

Effect of recombinant human granulocyte - macrophage colony - stimulating factor on expression of metalloproteinases and tissue inhibitors of metalloproteinase in residual burn wounds

作　　者：邱学文[1] 盛颖萍[2] 

机构地区：[1]南方医科大学南方医院烧伤科,广州510515 [2]黄埔出入境检验检疫局,广州510700

出　　处：《中华实验外科杂志》2017年第11期1946-1949,共4页Chinese Journal of Experimental Surgery

基　　金：广东省高等院校学科与专业建设专项资金项目（2013LYM_0007）

摘　　要：目的观察外用重组人粒细胞-巨噬细胞集落刺激因子（rhGM-CSF）对烧伤后残余创面基质金属蛋白酶（MMP）-1、MMP-2、MMP-13以及金属蛋白酶组织抑制剂（TIMP）-1、TIMP-2的影响。方法10例烧伤后残余创面患者，采用同体对照的研究方法，每例患者选取两处面积为16-25 cm2烧伤后残余创面，随机分为联合治疗组和对照组。联合治疗组创面外用rhGM-CSF凝胶剂及莫匹罗星软膏，对照组创面外用莫匹罗星软膏。观察用药后7、14 d的创面愈合率，记录创面愈合时间。于用药前及用药后7、14 d切取创面边缘组织标本，采用免疫组织化学法检测MMP-1、MMP-2、MMP-13、TIMP-1及TIMP-2的表达水平。结果用药7、14 d后，联合治疗组创面愈合率分别为（42±7）%、（86±6）%，均显著高于对照组[（35±8）%；t＝16.927，P＝0.000；（68±7）%，t＝41.849，P＝0.000]。联合治疗组创面平均愈合时间为（17.8±1.5） d，较对照组[（21.1±1.6） d]明显缩短（t＝－21.604，P＝0.000）。用药前两组创面MMP-1、MMP-2、TIMP-1及TIMP-2的表达水平均差异无统计学意义。用药后7、14 d联合治疗组MMP-1和MMP-2积分吸光度（IA）值分别为2 128±157、1 644±157和1 834±130、1 493±105，均显著低于对照组（3 653±181、3 060±175和2 350±121、2 064±109）。用药后7、14 d联合治疗组TIMP-1和TIMP-2的IA值分别为855±120、1 187±125和773±117、1 039±134，均显著高于对照组（590±111、846±101和614±91、808±124）。用药前后两组创面均未检测到MMP-13的表达。结论外用rhGM-CSF凝胶能促进烧伤后残余创面愈合，可能与其抑制创面MMP-1、MMP-2的表达或促进创面TIMP-1、TIMP-2的表达有关。Objective To investigate the effect of recombinant human granulocyte -macrophage colony - stimulating factor （rhGM - CSF） on the expression of metalloproteinases （MMP） - 1, MMP - 2, MMP- 13 and tissue inhibitors of metalloproteinase （TIMP） -1, TIMP- 2 in residual burn wounds. Methods The study was a randomized and self - controlled clinical trial. Ten patients with residual burn wounds were selected. Two residual burn wounds with area of 16 -25 cm^2 were selected from every patient and were divided into combined group （ with treatment of rhGM - CSF gel and mupirocin ointment ） and control group （ with treatment of mupirocin ointment） randomly. The wound healing rate at the 7th and 14th day after treatment and wound healing time were investigated. The wound tissue samples around the wounds before remedy and at the 7th and 14th day after remedy were obtained for evaluation of expression change of MMP - 1, MMP - 2, MMP - 13, TIMP - 1 and TIMP - 2 by immunohistochemistry. Results The wound healing rate in combined group was （42 ± 7 ）% and （86 ± 6）% respectively at the 7th and 14th day after remedy, which was obviously higher than that in control group [ （35 ± 8）% , t = 16. 927, P= 0. 000; （68±7）% , t =41. 849, P =0. 0001. The average wound healing time was （ 17.8±1.5） days in com- bined group, which was significantly shorter than that in control group [ （21.1 ± 1.6） days, t=- 21. 604, P = 0. 0001. Before remedy, the differences of MMP - 1, MMP - 2, TIMP - 1 and TIMP - 2 measured of two groups were not significant. At the 7th and 14th day after remedy, the integral optical den- sity （IA） of MMP- 1 （2 128± 157 and 1 644± 157 respectively） and MMP-2 （1 834± 130 and 1 493 ± 105 respectively） in the combined group were significantly decreased compared with control group （ MMP - 1 ： 3 653 ± 181 and 3 060 ± 175 ; MMP - 2 ： 2 350 ± 121 and 2 064 ± 109 ） respectively. The 1A of TIMP - 1 （855 ± 120 and 1 187 ± 125 respectively） and TIMP -2 （7

关 键 词：烧伤 粒细胞-巨噬细胞集落刺激因子 创面愈合 基质金属蛋白酶 

分 类 号：R644[医药卫生—外科学]