糖尿病合并创面难愈机制研究——表皮组织的病理生理改变  

Study on impaired wound healing in diabetes:the pathophysiological characteristics in epidermis

作　　者：陆树良[1] 谢挺[1] 董叫云[1] 王敏骏[1] 牛轶雯[1] 葛奎[1] 戎柳[1] 林炜栋[1] 花兰女[1] 金曙雯[1] 青春[1] 

机构地区：[1]上海第二医科大学附属瑞金医院

出　　处：《感染．炎症．修复》2004年第1a2期16-18,2,共4页Infection Inflammation Repair

基　　金：国家重点基础研究发展规划项目(G1999054205)

摘　　要：目的:了解糖尿病表皮组织在未遭受外源性损伤时存在的病理生理改变。方法:SPF 级 SD 大鼠12只,随机分为糖尿病实验组(6只)和正常大鼠对照组(6只),糖尿病大鼠以 STZ 诱导。成模后16d 两组同时采集背部皮肤,观察表皮的组织学特征,测定皮肤组织糖含量,检测表皮细胞的细胞周期。结果:糖尿病皮肤表皮细胞层次欠清晰,部分表皮缺乏复层排列,棘细胞数量明显减少,表皮层厚度明显变薄;S 期表皮细胞百分比与正常组无显著差异,G_2/M 期表皮细胞百分比均显著降低;皮肤组织糖含量明显高于正常组。结论:糖尿病表皮组织在未损伤、组织结构完整性未遭到破坏的情况下已经存在着组织学和细胞生物学行为的改变。这种异常改变可能是糖尿病皮肤易损或创面形成后难以愈合的重要原因之一。Objective:To elucidate the pathophysiological changes in diabetic epidermis.Methods:12 Sprague- Dawley rats weighing 200-220g were randomized into control group (n=6) and STZ-induced diabetic group (n= 6).The shaved skin specimens from the back of rats were collected on the 16th day post STZ-induction.The his- tological characteristics of the epidermis were examined.The local contents of glucose and the cell cycles of kerati- nocytes were determined.Results:The thickness of epidermis layer was reduced obviously in diabetic skin,with morphological characteristics of obscuring of multiplicity of epidermal cell layers.The results also revealed that content of glucose in diabetic skin was higher than that in the controls.In diabetic group,the percentage of S phase of keratinocytes showed no changes,while the percentage of G2/M phase of keratinocytes was obviously de- creased,when compared with the control group.Conclusion:The histological and pathophysiological alterations in the epidermis in diabetes mellitus has already occurred even when exogenous damage has not existed.The abnor- mality in the skin in diabetics might be a critical risk factor of ulceration and one of the most important mechanisms in the pathogenesis of impaired wound healing.

关 键 词：糖尿病 表皮组织 细胞增殖 

分 类 号：R58[医药卫生—内分泌]