CAJ | 학술논문

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。
목적：연구봉폐식부압인류술（VAC）치료애자병병인감염창면적 Bax 화 Bcl-2단백변화。방법40례애자병인분위VAC 치료조화대조조，대조조감염창면채용상규환약치료방법，VAC 치료조감염창면채용VAC 치료방법。관찰량조병인창면치료효과，면역조화검측감염창면세포적Bax 화Bcl-2단백표체。결과 VAC 치료적병인창면유합효과우우보통환약적병인，기중현효17례，유효2례，1례무효；대조조현효3례，유효14례，3례무효，량조유효병례차이구유통계학의의。량조환자치료전Bcl-2단백양성적세포수접근（P＞0．05），기간예치료후제3、7、14천위6±1．5／HP、10±2．3／HP、14±2．7／HP、15±3．2／HP，고우대조조적5±1．2／HP，6±2．1／HP，6±1．8／HP，7±0．9／HP。동양，량조환자치료전적 Bax 단백양성세포수비교무통계학차이，단제3、7、14천，VAC 치료조감염창면 Bax 단백양성적세포수분별14±3．2／HP，13±3．5／HP，10±3．1／HP，5±1．2／HP，균현저저우대조조병인적13±2．8／HP、12±3．2／HP、11±3．1／HP、10±2．5／HP（P＜0．05）。결론 VAC 능구촉진애자병감염창면적유합，기궤제가능여하조 Bax 화 Bcl-2단백표체억제세포조망유관。
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 AiDS 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.