金疮油膏对压疮创面血管内皮细胞增殖和迁移的影响

Influence of Jinchuang Cream on the Proliferation and Migration of Vascular Endothelial Cells in Pressure Ulcers

目的探讨金疮油膏对压疮患者创面血管内皮细胞增殖和迁移的影响。方法将2014年1月-2015年12月上海市第二人民医院收治的306例压疮患者(512处压疮创面)按随机数表法分为传统压疮膏治疗组(102例)、金疮油膏治疗组(102例)和美皮康银治疗组(102例)。分别于治疗前和治疗后第7、14、21天对各组患者压疮创面进行PUSH评分,对比各组药物治疗效果;在治疗前和治疗后第21天,分别取各组患者压疮创面组织进行免疫组织化学染色、免疫荧光染色和蛋白质免疫印记检测,观察各组患者创面血管内皮细胞增殖细胞核抗原(Proliferation Cell Nuclear Antigen,PCNA)和磷酸化黏着斑激酶(Foeal Adhesion Kinase,FAK)的表达,以判断各组药物对血管内皮细胞增殖和迁移的影响。结果三组患者压疮创面PUSH评分比较,治疗第14天及第21天,金疮油膏治疗组患者创面PUSH评分降低程度明显高于传统压疮膏治疗组和美皮康银治疗组(P<0.05),传统压疮膏治疗组和美皮康银治疗组对比,差异无统计学意义(P>0.05),即金疮油膏治疗压疮创面疗效最佳;三组患者压疮创面组织学检测结果对比,治疗后血管内皮细胞p-FAK和PCNA水平均较治疗前增加,其中以金疮油膏组增加最为明显,即金疮油膏可明显促进压疮创面血管内皮细胞的增殖和迁移。结论金疮油膏可通过激活血管内皮细胞FAK通路,上调PCNA表达而促进压疮创面血管内皮细胞的增殖和迁移,进而促进创面血管形成,加速创面愈合,疗效优于传统压疮膏和美皮康银。

Objective To explore the influence of Jinchuang Cream on the proliferation and migration of vascular endothelial cells in pressure ulcers.Methods Three hundred and six patients with 512 pressure ulcer wounds admitted into the Shanghai Second People＇s Hospital between January 2014 and December 2015 were evenly divided into a group treated with traditional cream for pressure ulcer（traditional group）,a group treated with Jinchuang Cream（Jinchang group） and a group treated with Mepilex Ag（Mepilex Ag group） according to the random number table.The pressure ulcer wounds in each group were scored before the treatment and on day 7,14 and 21 after the treatment to compare the therapeutic effects between the three groups.Before the treatment and on day 21 after the treatment,the immunohistochemical staining,immunofluorescence staining and western blotting technology were performed on the ulcer tissues in each group to observe the expression of Proliferation Cell Nuclear Antigen（PCNA） and phospho-FAK（Focal Adhesion Kinase） in vascular endothelial cells in each group,so as to assess the influence of drugs in each group on the proliferation and migration of vascular endothelial cells.Results The comparison of PUSH（pressure ulcer scale for healing） scores between the three groups on day14 and 21 after the treatment showed that the PUSH scores in the Jinchuang group decreased more significantly than that in the traditional group and Mepilex Ag group（P〈0.05）,while the comparison of PUSH scores in the traditional group and Mepilex Ag group showed no statistically significant difference（P〉0.05）,which demonstrated that Jinchuang Cream had the best therapeutic effects in pressure ulcers.The histological examination results in the three groups showed the after-treatment levels of p-FAK and PCNA in vascular endothelial cells all increased compared with that before the treatment,of which the increases in the Jinchuang group were more significant,indicating Jinchuang Cream can remarkably promote the proliferation and migration of vascular endothelial cells in pressure ulcers.Conclusion Jinchuang Cream can promote the proliferation and migration of vascular endothelial cells in pressure ulcers by activating the FAK pathway and up-regulating the expression of PCNA in vascular endothelial cells,facilitating the wound vascular formation and speeding up wound healing,with superior therapeutic efficacy to that of traditional pressure ulcer cream and Mepilex Ag.