去炎松-A和5-氟脲嘧啶混合液对增生性瘢痕胶原代谢影响的实验研究  

An experimental study on collagen metabolism in hypertrophic scars after treatment with intralesional triamcinolone acetonide mixed with 5-fluorouracil

作　　者：崔子伟[1] 郝立君[2] 肖志波[2] 任丽虹[2] 王洁[2] 庞建华[2] 宋淑民[2] 杨宝峰[3] 

机构地区：[1]哈尔滨医科大学整形外科,黑龙江哈尔滨150086 [2]哈尔滨医科大学附属第二医院整形美容中心,黑龙江哈尔滨150086 [3]哈尔滨医科大学药理教研室,黑龙江哈尔滨150086

出　　处：《中国实用美容整形外科杂志》2004年第5期268-271,共4页

摘　　要：目的　探讨TAC和 5 -FU混合液对增生性瘢痕胶原代谢的影响。方法　用兔耳建立增生性瘢痕动物模型 ,随机分成四组 ,在瘢痕局部注射TAC和 5 -FU混合液为A组、注射TAC为B组、注射 5 -FU为C组、对照为D组 ,每周注射 1次 ,第 4次注射后 1周观察组织学改变 ,测定瘢痕内HPr、PCⅢ的含量 ,Ⅰ、Ⅲ型胶原面积及比例。结果　①组织学 :D组呈现出增生性瘢痕的病理特征 ,A、B、C三组呈现胶原纤维溶解 ,成纤维细胞的超微结构受到明显影响。②HPr和PCⅢ含量测定 :A、B、C、D四组之间比较差异有显著意义 (P <0 .0 5 ) ,A组含量最低 ,D组含量最高。③Ⅰ、Ⅲ型胶原面积及比例测定 :A、B、C、D四组Ⅰ、Ⅲ型胶原面积差异有显著意义 (P <0 .0 5 ) ,A组Ⅰ型胶原比例最低。结论　TAC和 5 -FU混合液能有效抑制增生性瘢痕内胶原的合成 ,降解胶原纤维 ,对Ⅰ型胶原的抑制比Ⅲ型胶原强 ,改善Ⅰ、Ⅲ型胶原的构成比 ,作用强于单纯的应用TAC或 5 -FU。Objective To evaluate the effect and possible mechanisms of intralesional triamcinolone acetonide mixed with 5-fluorouracil on collagen metabolism in hypertrophic scars. Methods Rabbit ears were used to establish animal model for hypertrophic scar,which was randomly divided into four groups. The hypertrophic scars were injected intralesionally with TAC mixed with 5-fluorouracil (group A), triamcinolone acetonide (group B), 5-fluorouracil (group C), and control group (group D) once a week. On the first week after the fourth treatment, specimens from these rabbit ears were biopsied for histological examination. Furthermore, determine the contents of HPr, PCⅢ and the areas of typeⅠand Ⅲ collagen as well as the proportion of typeⅠto Ⅲ collagen in the scars. Results ① Histologically, group D exhibited pathologic feature of hypertrophic scars, ultrastructure of fibroblast was affected sinificantly in group A, B and C. ② There were statistically differences among mean values of HPr and PCⅢ contents in group A, B, C and D. HPr and PCⅢ contents of group A were statistically lower than that of other three groups. ③ There were statistically differences among mean values of the areas of typeⅠand typeⅢ collagen in these four groups. The proportions of type Ⅰ collagen of group A were lower than that of other three groups. Conclusion Intralesional TAC mixed with 5-fluorouracil5-FU may effectively inhibit collagen synthesis and degrade collagen fiber and inhibit type Ⅰ collagen more than typeⅢ, bettering the proportion of typeⅠtoⅢ collagen, this efficacy was stronger than that of triamcinolone acetonide C or 5-fluorouracil alone.

关 键 词：TAC 5-FU 增生性瘢痕 HPR PCⅢ Ⅰ、Ⅲ型胶原 

分 类 号：R622[医药卫生—整形外科]