兔耳增生性瘢痕与血管内皮抑制素的抑制  

Hyperplastic scar in ears of rabbits and the inhibitory effect of rh-endostation

作　　者：宋保强[1] 鲁开化[1] 郭树忠[1] 李荟元[1] 郝林源[1] 夏炜[1] 马福成[1] 张翠翠[1] 

机构地区：[1]解放军第四军医大学西京医院整形外科中心,陕西省西安市710032

出　　处：《中国临床康复》2005年第18期111-113,共3页Chinese Journal of Clinical Rehabilitation

基　　金：国家自然科学基金(30271346)~~

摘　　要：目的:从外观形态、微血管计数、微循环血流灌注、组织形态学方面观察血管内皮抑制素对兔耳增生性瘢痕的抑制作用。方法:实验于2003-08/11在第四军医大学西京医院整形外科实验室完成。日本大耳白兔10只,随机将每只兔子的一只耳归入实验组,另一只归入对照组,每组10只兔耳。两组均进行增生性瘢痕动物模型的复制。兔耳创面上皮化后10d,实验组瘢痕组织局部多点注射血管内皮抑制素,对照组瘢痕组织局部多点注射生理盐水,两组注射剂量及频率为0.2mL/次,1次/隔日,连续6次。30d后观察两组瘢痕组织外观形态、微血管计数、微循环血流灌注以及病理组织形态学的差异。结果:20只兔耳全部进入结果分析。①外观形态变化:实验组瘢痕明显萎缩,略高出兔耳皮肤表面,颜色接近兔耳正常肤色,触之质软;对照组瘢痕呈增生期表现,明显高出兔耳皮肤表面,淡红色,质地坚硬。②微血管计数结果:实验组瘢痕组织表面微血管数量明显减少,散在分布;对照组瘢痕组织表面微血管数量丰富,相互交织成网状;40倍显微镜下微血管计数实验组明显低于对照组[(17.63±3.34),(51.23±5.54)个,P<0.01]。③微循环血流灌注变化:实验组明显低于对照组[(21.16±3.12),(64.27±4.28)个,P<0.01]。④病理组织形态学差异:实验组瘢痕组织真皮层变薄,血管及成纤维细胞数量明显减少,胶原纤维较细致,排列有序,呈成熟期表现;对照组瘢痕组织可见大量成纤维细胞,血管分布丰富,其间可见较多的炎细胞浸润,胶原纤维粗大,排列紊乱,呈增生期表现。结论:血管内皮抑制素对兔耳瘢痕增生及瘢痕组织的血管生成、微循环血流有明显的抑制作用,提示血管的发生与增生性瘢痕的形成有着密切关系,在增生性瘢痕形成早期有针对性的进行血管靶向治疗可有效抑制增生性瘢痕的形成。AIM: To observe the inhibitory effect of rh- endostatin (YH- 16) on the hyp erplastic scar in ears of the rabbits from appearance, microvessel counting, blo od flow perfusion of microcirculation and tissue morphology. METHODS: The experiment was conducted in the Laboratory of Department of Plas tic Surgery, Xijing Hospital, Fourth Military Medical University of Chinese PLA from August to November in 2003.Ten Japanese flap- eared rabbits were chosen as experiment animals and an ear of a rabbit was classified into the experiment gr oup randomly, and the other one into the control group. There were ten ears in e ach group.Then, rabbits with hypertrophic scar in ears were reproduced in the bo th groups.Ten days after re- epithelization, YH- 16 was locally injected into the scar tissue in the rabbit's ears in the experiment group, and normal saline was used in the control group.The injection dosage and frequency of the two grou ps was 0.2 mL once every other day for 6 successive times.Thirty days later, the difference of the appearance of scar, microvessel counting, blood flow perfusio n of microcirculation as well as pathologic tissue morphology were observed. RESULTS: All the ears of ten rabbits entered the result analysis.① Change of appearance:After injection of YH- 16, the scar in ears of rabbits in the exper iment group became depauperate markedly, higher than the skin surface slightly, close to the normal skin in colour and soft when touching; but it appeared proli ferative in the control group and was higher than the skin surface obviously wit h light red in colour and hard when touching. ② Result of microvessel counting : The number of microvessel in scar tissue in the experiment group was decreased markedly and the microvessels were scattered; there were many microvessels in s car tissue in the control group and they were distributed nestedly ;the microves sel counting under the 40× field microscope was obviously lower in the experime nt group ( 17.63± 3.34) than that in the control group ( 51.23± 5.5

关 键 词：瘢痕 肥大性 增生 抑制素 毛细血管 成纤维细胞 新生血管化 病理性 

分 类 号：R619[医药卫生—外科学]