外用盐酸罂粟碱抑制植皮片术后挛缩作用机理的实验研究  

Experimental study on mechanism of inhibition of skin grafts contraction with papaverine cream

作　　者：王黔[1] 王佳琦[1] 栾杰[1] 唐勇[1] 范金才[1] 庄强[1] 贾春实[1] 戚可名[1] 

机构地区：[1]中国医学科学院中国协和医科大学整形外科医院整形八科,北京100144

出　　处：《中国美容医学》2009年第6期809-813,共5页Chinese Journal of Aesthetic Medicine

摘　　要：目的:探讨外用盐酸罂粟碱抑制植皮片术后挛缩的作用机理。方法:取18只大鼠36侧移植皮片作为实验对象,将大鼠分成测量组及取材组,同一只大鼠的植皮片按左右侧对应位置进行配对,分成A(罂粟碱治疗组)、B(空白霜剂对照组)2组。A组每日在植皮片表面外涂2%罂粟碱霜2次,B组仅涂抹空白对照霜剂,术后90天后,A、B两组改为全部应用空白霜剂。最后观察两组术后10、20、40、60、90、120天收缩率变化及α-SMA免疫组化染色、天狼猩红染色的组织学变化。结果:外用盐酸罂粟碱霜可以有效地抑制大鼠植皮片术后挛缩,免疫组化染色显示:应用盐酸罂粟碱霜后,皮片创面中的肌成纤维细胞(MFB)数量较对照组明显减少。天狼猩红染色显示用药组皮片的Ⅰ/Ⅲ型胶原比值较用药组降低。结论:外用罂粟碱霜剂能够抑制自体游离植皮片术后挛缩,其作用机理在于盐酸罂粟碱可以明显减少皮片下肌成纤维细胞(myofibroblast MFB)的数量并降低Ⅲ/Ⅰ型胶原比值从而抑制了植皮片的挛缩。Objective To study the mechanism of inhibition of skin grafts contraction With Papaverine Cream. Methods Prepare 36 pairs of skin grafts on the back of 18 rats. Divide the 18 rats to measurement group （12） and material （6） group. Chose the same position from left and right site of each rat and divided them into group A （left）as experiment group and group B （right） as control group. From the day of suture removal, group A used 2% papaverine cream on the skin graft. Group B used plain cream as the control. Used plain cream to both groups after 90 days post-operation. The records started at 10, 20, 40, 60, 90, and 120 days after suture removal. Calculated the grafts shrinking ratio. Used immunohistochemistry staining and Sirius red staining to observe skin graft tissue structure. Results The group A had less grafts contraction and coincided with statistics. The immunohistochemistry staining showed that the expression of anti-smooth muscle actin （α-SMA） of group A is significantly greater than group B after application of papaverine. The Sirius red staining showed that the ratio of collagen Ⅲ/Ⅰ were lower in group A than group B. Conclusions External use of papaverine cream can inhabit the contraction of skin grafts. The mechanism of this action reside in the quantitative reduction of myofibroblast （MFB） and ratio of collagen Ⅲ/Ⅰ.

关 键 词：游离植皮 罂粟碱 植皮片挛缩 肌成纤维细胞Ⅲ/Ⅰ型胶原比值 

分 类 号：R622[医药卫生—整形外科]