玫及乳膏促进大鼠Ⅲ期压疮溃疡愈合的实验研究

Experimental Study of Meiji Cream to Promote Healing of Pressure Ulcer of Rats in Ⅲ Period

目的观察玫及乳膏对大鼠Ⅲ期压疮模型新生肉芽组织中基质金属蛋白酶-2(MMP-2)、纤维结合蛋白(FN)、转化生长因子-β1(TGF-β1)及血管内皮生长因子(VEGF)的影响并分析其作用机制。方法 SD大鼠120只,随机选取其中的80只采用左侧臀肌下埋置铁片外加磁片循环压迫造成局部表皮缺血-再灌注损伤的方法建立Ⅲ期压疮模型,成模后随机分为模型组和实验组,另40只不造模设为空白对照组。实验组在压疮溃疡面涂敷玫及乳膏,空白对照组和模型组外敷生理盐水纱布对照。于治疗的1、3、7、14 d时取新生肉芽组织采用免疫组化检测MMP-2、FN、TGF-β1及VEGF含量,并统计显效、愈合时间、愈合速度和愈合率。结果与模型组比,实验组显效和愈合所需时间缩短、创面愈合率和愈合速度提高(P<0.05);实验组在第7日时MMP-2含量降低达低峰,在第14日时FN、TGF-β1及VEGF含量最高且达峰值,实验组与模型组在第7日和14日时MMP-2、FN、TGF-β1及VEGF含量的差异有统计学意义(P<0.05)。结论玫及乳膏可通过抑制MMP-2合成来降低纤维蛋白及细胞基质、并能促进大鼠Ⅲ期压疮溃疡面新生肉芽组织中FN、TGF-β1及VEGF的表达,提高创面愈合率和愈合速度,从而加速压疮溃疡面组织修复。

Objective： To investigate the influences of Meiji Cream on MMP-2,FN,TGF-β1 and VEGF in the granulation tissue of model rats with pressure ulcer in III period,and to analyze its mechanism. Methods： 80 SD rats randomly selected from 120 were caused local skin ischemia reperfusion injury to make stage III model with external magnetic implanted under bilateral gluteal muscle with iron cycle oppression. After modeling,the rats were randomly divided into the model group and the experimental group ,and the other 40 rats were set to the blank control group. The experimental group were coated of Meiji Cream on pressure ulcer surface. The control group and the model group ＂applied physiological Shiomizu Sabu as comparasion. The granulation tissue was taken on lst,3rd,7th and lgth d,and the levels of MMP-2,FN and TGF-β1 and contents of VEGF were detected by immunohistochemistry,and the effective time,healing speed and healing rate were counted. Results： Compared with the model group, effectual time and the time for healing of the experimental group was shortened, and the healing rate and healing speed of the wound were increased （P〈 0.05）. On the seventh day, the content of MMP-2 in the experimental group decreased and reached a low peak. On the fourteenth day,the content of FN,TGF-β1 and VEGF was the highest and reached the peak. The differences of MMP-2,FN,TGF-β1 and VEGF in the ex- perimental group and the model group on the seventh and the fourteenth days were statistically significant （P〈 0.05）. Conclusion： Meiji Cream can promote the expression of MMP-2,FN,TGF-β1 and VEGF of surface granulation tissue in rats with pressure ulcer in Ⅲ period,thus improving the wound healing rate and healing speed, and then accelerating repairing pressure ulcer tissue.