基质金属蛋白酶及其组织抑制因子与糖尿病足

Matrix-metalloproteinases and their inhibitors in diabetic foot

创面修复是一个复杂而有序的生物学过程，许多重要过程均受细胞因子和蛋白酶的调节。研究表明糖尿病患者足部伤口中基质金属蛋白酶（MMPs）表达增加，其抑制因子基质金属蛋白酶组织抑制因子（TIMPs）表达减少，导致伤口难以愈合。MMPs与TIMPs的比例可能比它们的绝对浓度更重要，是预测伤口愈合的重要指标，与伤口愈合时间呈负相关。局部应用强力霉素、一些含蛋白酶抑制剂的敷料以及促有丝分裂的牛血清提取物等均可通过抑制MMPs促进创面愈合。

Wound healing is a complex and orderly biological process, and essential processes of normal wound healing are mainly regulated by cytokines and proteases. Many researches show that the concentrations of matrix metalloproteinases（MMPs） are increased, but the expression of tissue inhibitors of matrix metalloproteinases （TIMPs） are decreased leading to delayed wound healing. It is likely that the ratio of MMPs to TIMPs is more important than the absolute concentrations of either, and it is an importart predict factor of wound healing time, which has negative correlation with the ratio of MMPs to TIMPs. Local application of doxycycline, dressings that contain the inhibitors of proteases and mitogenic bovine whey extract can reduce the concentration of MMPs and promote the progress of wound healing.