糖尿病皮肤组织及创面增殖细胞核抗原和蛋白质P53表达对增殖修复能力的影响

Effect of expression of proliferating cell nuclear antigen and P53 protein on the proliferative and repair ability in diabetic skin and wound

目的:探讨糖尿病创面难愈发生的可能机制,研究增殖细胞核抗原,蛋白质P53在糖尿病皮肤组织及创面中的表达对增殖修复能力的影响。方法:实验于2003-04/10在广西医科大学第一附属医院和上海市烧伤研究所完成。12例需手术治疗的糖尿病足部溃疡患者供皮区12个创面作为观察对象,同部位非糖尿病手术者12例作为对照。切取皮肤组织后以及术后第3天或第7天或第14天再次切取创面组织作为标本,免疫组化方法检测标本增殖细胞核抗原,P53蛋白。结果:糖尿病皮肤组织与非糖尿病皮肤组织均存在一定的增殖细胞核抗原,P53蛋白表达,但糖尿病皮肤组织与非糖尿病比较,增殖细胞核抗原,P53蛋白表达更多。而在创面组织修复过程中,糖尿病创面增殖细胞核抗原,P53蛋白表达明显少于非糖尿病创面。结论:糖尿病皮肤组织在创伤前就可能存在着一系列的分子生物学异常,从而影响糖尿病创面组织的增殖修复能力,使糖尿病创面的愈合明显滞后于非糖尿病创面的愈合。

AIM:To probe into the mechanism of diabetic non-healing and investigate expression of proliferating cell nuclear antigen(PCNA) and P53 protein in diabetic skin and wound to affect the proliferative and repair ability. METHODS:The study was finished in the First Affiliated Hospital of Guangxi Medical University and Shanghai Institute of Burns from April to October 2003.Twelve wound sites were studied among the donor sites in 12 patients with diabetic foot ulcer,meanwhile another 12 donor sites in 15 non-diabetic patients having undertaken surgery were as controls.The specimens were gotten immediately after incising skin and re-incising on the 3rd,7th,14th day after first incision.PCNA and P53 protein in the wound sites were detected with immunohistochemistry. RESULTS:There was much more expression of PCNA and P53 protein in diabetic skin tissue than in non-diabetic skin tissue even though both of them having a little bit expression.But during the wound repairing,much less expression of PCNA and P53 protein in diabetic skin tissue compared with non-diabetic skin tissue. CONCLUSION:The study reveals that there are serious abnormity on molecular biology in diabetic skin tissue before injury which can affect the ability of tissue proliferation and repair,and make wound healing of diabetic skin tissue later than that of non-diabetic skin tissue obviously.