目的：研究封闭式负压引流技术对人压力性溃疡S100A9蛋白的表达影响以探讨其促进创面愈合的可能机制。方法：将28例Ⅲ－Ⅳ期及不可分期的压力性溃疡患者随机分成实验组（14例）和对照组（14例），实验组患者创面应用封闭式负压引流治疗，对照组患者创面应用常规敷料换药治疗，两组患者分别于治疗前1 d，治疗后4 d、7 d、14 d取创面创缘全层皮肤组织，应用免疫组织化学染色法检测标本组织中的S100A9蛋白的表达情况。结果：随着治疗时间延长，实验组和对照组S100A9蛋白阳性表达细胞数开始增加，都表达于中性粒细胞及单核巨噬细胞的细胞质中，治疗第14天，实验组肉芽组织中表达S100A9蛋白的炎症细胞数高于对照组（75．93±1．88 vs 55．13±1．03， P＜0．01）。结论：封闭式负压引流疗法较普通换药更能够上调创缘组织中与创面愈合密切相关的S100A9蛋白表达来促进创面愈合。%Objective: To investigate the expression of S100A9 in the pressure ulcer wound tissue with vacuum assisted closure (VAC) on pressure ulcer (PU), and to explore its further mechanism which can facilitate healing of PU wound. Methods: 28 patients with Stage Ⅲ-Ⅳ and unstageable pressure ulcer wounds were divided into the experimental group (n=14) and the control group (n=14) randomly. The experimental group was treated with VAC, while the control group was treated with dressings. The full-thickness skin tissues were selected from every patient for immunohistochemistry (IHC) to evaluating the expression of S100A9 protein at pre-treatment, and the 4th day, 7th day, 14th day after treatment with VAC and dressings. Results: With the treatment process developed, the positive staining of S100A9 protein were both located in the neutrophil and mononuclear macrophage , and the number of positive cells became increased. The expression of S100A9 protein in target cells was more in the experimental group than that of control group at the 14th day after therapy (75.93 ±1.88 vs 55.13 ±1.33, P<0.01). Conclusion:Compared with dressings, VAC is a more effective method that induced the expression of S100A9 in the edge of wound, which is closely correlated with wound healing, to facilitate healing of pressure ulcer.
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