真皮及脂肪组织创伤后愈合差异性观察  

Differences in wound healing between wounded dermal and adipose tissues

作　　者：原博[1] 王西樵[1] 姜育智[1] 韦俊[1] 王志勇[1] 缪明远[1] 宋菲[1] 花兰女[1] 陆树良[1] 

机构地区：[1]上海交通大学医学院瑞金医院上海市烧伤研究所,上海200025

出　　处：《上海交通大学学报（医学版）》2009年第4期408-411,425,共5页Journal of Shanghai Jiao tong University:Medical Science

基　　金：国家重点基础研究发展规划项目("九七三"计划)(2005CB522603-3)~~

摘　　要：目的观察真皮和脂肪组织创伤愈合的差异性,探讨脂肪组织创伤在瘢痕形成中的作用。方法以杜洛克母猪为实验动物,用滚轴取皮刀在同一个体背部制作真皮及脂肪组织切割(n=6)或缺损(n=1)创面,采用自身配对观察比较创伤后1、2、4及12周的大体愈合情况。对于真皮及脂肪组织切割伤创面,于创伤后1、2、3周在创面中央取材,观察创伤处组织学改变,免疫组化法观察创面修复细胞表面分子Ⅰ型胶原α2、瘦素及α平滑肌肌动蛋白的表达。结果从创面中央看,瘢痕只出现在真皮组织切割伤和真皮组织缺损模型。真皮及脂肪组织切割伤同体配对比较结果显示,前者切缘处新生胶原沉积量要多于后者,且胶原类型存在差异;但两者创伤处修复细胞均以成纤维样细胞为主,细胞表面分子Ⅰ型胶原α2、瘦素及α平滑肌肌动蛋白呈阳性表达。结论真皮组织损伤或缺失是形成瘢痕的主要因素,而脂肪组织损伤或缺失与瘢痕的形成并无直接相关性。与真皮组织切割伤相比,脂肪组织切割伤的创伤处纤维化的程度较轻。Objective To observe the differences in wound healing between wounded dermal and adipose tissues, and explore the role of wounded adipose tissues in the formation of cutaneous scars. Methods Female red Duroc pigs were served as experimental animals, and dermal and adipose tissue incised （n = 6）or lacked wounds（ n = 1 ）were made on each pig g back using roller dermatome. The megascopic observations of wound healing of each pig in 1, 2,4, and 12 weeks were conducted. For the dermal and adipose tissue incised wounds, the samples in the center of wound areas were harvested in 1, 2 and 3 weeks, the histological changes of wound within dermal or adipose tissues were observed, and the expression of α2 chain of collagen type I, leptin and α-SMA protein in reparative cells in wound areas was detected. Results In the center of wound areas, scars were only found in dermal tissue incised and lacked wounds. Compared the dermal tissue incised wounds with adipose tissue incised wounds in the same individual animal, there existed more neogenesis of collagen in wound edges in the former, and thery had different types of collagen. However, fibroblasts constituted most of the reparative cells in the above two kinds of wounds, and α2 chain of collagen type I , leptin and α-SMA protein were positively expressed. Conclusion The injury and lack of dermal tissues, instead of adipose tissues, contributed a lot to the formation of cutaneous scars. The adipose tissue incised wounds may develope less fibrogenesis than dermal tissue incised wounds do.

关 键 词：真皮 脂肪 瘢痕 切割伤 胶原 成纤维细胞 

分 类 号：R641[医药卫生—外科学]