摘要
目的研究封闭式负压引流术(VAC)治疗艾滋病病人感染创面的Bax和Bcl-2蛋白变化。方法 40例艾滋病人分为VAC治疗组和对照组,对照组感染创面采用常规换药治疗方法,VAC治疗组感染创面采用VAC治疗方法。观察两组病人创面治疗效果,免疫组化检测感染创面细胞的Bax和Bcl-2蛋白表达。结果 VAC治疗的病人创面愈合效果优于普通换药的病人,其中显效17例,有效2例,1例无效;对照组显效3例,有效14例,3例无效,两组有效病例差异具有统计学意义。两组患者治疗前Bcl-2蛋白阳性的细胞数接近(P>0.05),其干预治疗后第3、7、14天为6±1.5/HP、10±2.3/HP、14±2.7/HP、15±3.2/HP,高于对照组的5±1.2/HP,6±2.1/HP,6±1.8/HP,7±0.9/HP。同样,两组患者治疗前的Bax蛋白阳性细胞数比较无统计学差异,但第3、7、14天,VAC治疗组感染创面Bax蛋白阳性的细胞数分别14±3.2/HP,13±3.5/HP,10±3.1/HP,5±1.2/HP,均显著低于对照组病人的13±2.8/HP、12±3.2/HP、11±3.1/HP、10±2.5/HP(P<0.05)。结论VAC能够促进艾滋病感染创面的愈合,其机制可能与下调Bax和Bcl-2蛋白表达抑制细胞凋亡有关。
Objective To investigate the expression of Bax and Bcl-2 protein in the wound tissues in AIDS paitents and the effect of vacuum-assisted closure（VAC） on wound healing.Methods Forty Ai DS patients with infective wound were selected and divided VAC treatment group（VAC group, n =20） and conventional dressing therapy group（control group, n =20）. Bax and Bcl-2 protein expression were determined before treatment and in 3,7 and 14 days after different treatment, respectively. Results The VAC group had obvious healing effect, including the markedly effective in 17 cases, the effective in 2 cases, the ineffective in one, while the markedly effective was in 3 cases,the effective in 14 cases,the ineffective in 3 cases in conventional treatment group. There were no significant differences in Bcl-2 protein expression between two groups before treatment（P 0.05）. Bcl-2 expression was increased significantly in VAC group than that in control group in 3,7,14 days after treatment（P 0.01）. There were no significant differences in Bax protein expression between two groups before treatment, but level of Bax expression in VAC group was significantly lower than that in control group in 3,7,14 days after treatment（P 0.01）.Conclusion In the present study, VA C treatment promoted wound healing in AIDS patients, which was associated with. Bcl-2 protein up-regulation and Bax down-regulation.
出处
《岭南现代临床外科》
2015年第2期162-165,共4页
Lingnan Modern Clinics in Surgery
基金
广东省科技计划项目(2010B031600181)
