AgNP敷料促进深度烧伤致慢性难愈性创面修复的效果及VEGF/MMP-9信号通路机制研究  

Effect of AgNP dressing on the healing of chronic refractory wounds caused by deep burn and the mechanism of VEGF/MMP-9 signaling pathway

作　　者：牛晓暐[1] 李建友 李田田[1] 吴珣[1] NIU Xiao-wei;LI Jian-you;LI Tian-tian(Department of Vascular Surgery,Beijing Traditional Chinese Medicine Hospital,Capital Medical University,Beijing 100010,China;Pinggu Hospital of Beijing Traditional Chinese Medicine Hospital,Beijing 101299,China)

机构地区：[1]首都医科大学附属北京中医医院血管外科,北京100010 [2]北京中医医院平谷医院血管外科,北京101299

出　　处：《临床和实验医学杂志》2022年第11期1208-1211,共4页Journal of Clinical and Experimental Medicine

基　　金：北京市科学技术委员会项目(编号:Z161100000516149)。

摘　　要：目的研究稳定剂合成纳米银(AgNP)敷料促进深度烧伤致慢性难愈性创面修复的效果及血管内皮细胞生长因子/基质金属蛋白酶-9(VEGF/MMP-9)信号通路机制。方法前瞻性选取2019年5月至2021年6月首都医科大学附属北京中医医院收治的74例深度烧伤致慢性难愈性创面患者作为研究对象,采用随机数字表法分为试验组(n=37)和对照组(n=37)。对照组患者接受常规伤口处理,试验组则在对照组基础上给予AgNP敷料治疗。对比两组患者治疗前后创面病原菌阳性率、伤口肉芽形态评分、VEGF以及MMP-9水平;对比两组患者不良反应发生率。结果治疗后,试验组创面病原菌阳性率为16.21%,显著低于对照组(37.83%),差异有统计学意义(P<0.05)。治疗后,试验组伤口肉芽形态评分为(0.89±0.14)分,显著低于对照组[(1.56±0.21)分],差异有统计学意义(P<0.05)。治疗后,试验组血清VEGF为(736.98±10.55)pg/mL,显著高于对照组[(683.64±10.57)pg/mL],MMP-9为(2.08±0.52)μg/L,显著低于对照组[(3.54±0.61)μg/L],差异均有统计学意义(P<0.05)。试验组与对照组不良反应发生率相比(2.70%vs.5.40%),差异无统计学意义(P>0.05)。结论对于AgNP深度烧伤致慢性难愈性创面患者,AgNP敷料对于创面的修复效果较高,可降低MMP-9并提高VEGF,且安全性较高。Objective To study the effect of silver nanoparticles(AgNP)dressing on the healing of chronic refractory wounds caused by deep burn and the mechanism of vascular endothelial growth factor/matrix metalloprotein-9(VEGF/MMP-9)signaling pathway.Methods Seventy-four patients with chronic refractory wounds caused by deep burn in Beijing Traditional Chinese Medicine Hospital,Capital Medical University from May 2019 to June 2021 were prospective enrolled,and divided into two groups by random number table methods,37 cases in each group.Control group received routine treatment,based on this,experimental group received AgNP dressing.The positive rate of wound secretion pathogens,morphology of granulation tissue,VEGF and MMP-9 levels,and the incidence of adverse effects was compared between two groups.Results The positive rate of wound secretion pathogens was 16.21%in experimental group,which was significantly lower than that in control group(37.83%),the difference was statistically significant(P<0.05).After treatment,the scores of morphology of granulation tissue in the experimental group was(0.89±0.14)points,which was significantly lower than that in the control group[(1.56±0.21)points],and the difference was statistically significant(P<0.05).After treatment,the serum VEGF of the experimental group was(736.98±10.55)pg/mL,which was significantly higher than that of the control group[(683.64±10.57)pg/mL],and the MMP-9 was(2.08±0.52)μg/L,which was significantly lower than that of the control group[(3.54±0.61)μg/L],the differences were statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the experimental group and the control group(2.70%vs.5.40%)(P>0.05).Conclusion Application of AgNP dressing in the treatment of chronic refractory wounds caused by deep burn can effectively improve the wound healing rate,down-regulate MMP-9 level and up-regulate VFGF level,with high safety.

关 键 词：深度烧伤 AgNP敷料 慢性难愈性创面 血管内皮细胞生长因子/基质金属蛋白酶-9信号通路 

分 类 号：R644[医药卫生—外科学]