异体脱细胞真皮基质对大鼠皮肤瘢痕形成的影响  

Experimental study on accelular dermal matrix inhibiting skin scar

作　　者：张烨峰[1] 郑锦标[1] 白肃[1] 杨丽娜[1] 陈楚义[1] 徐继庆[1] 

机构地区：[1]深圳市龙岗区人民医院烧伤整形外科,518172

出　　处：《中华损伤与修复杂志（电子版）》2009年第2期6-9,共4页Chinese Journal of Injury Repair and Wound Healing(Electronic Edition)

摘　　要：目的了解异体脱细胞真皮基质(accelular dermal matrix,ADM)对SD大鼠皮肤切口愈合后瘢痕形成的影响。方法4%NaOH溶液消蚀脱细胞法制备ADM,选用SD大鼠56只,每只大鼠背部脊柱两侧共做两道平行切口,建立皮肤切口模型。按自身对照分为实验组及对照组,实验组:将修剪成的ADM(3cm×0.3cm×0.1cm)植入切口,丝线缝合切口;对照组则原位缝合。术后3天、5天、7天、14天、21天、28天、63天(每个时相点8只)处死大鼠,取切口皮肤组织做HE、Masson染色,进行生物组织学检测,RT-PCR方法检测各组切口中成纤维细胞内Ⅰ型前胶原mRNA的表达水平。结果术后实验组未见明显瘢痕组织,而对照组愈合后见明显线性瘢痕形成。镜下观察实验组切口中ADM逐渐被改建成自体组织,3天、5天、7天、14天及21天实验组中成纤维细胞数量较对照组减少(P<0.05);实验组切口中胶原的生成在各个时间点较对照组均减少,其中7天、14天、21天、28天及63天实验组切口中胶原的生成较对照组明显减少(P<0.01);RT-PCR检测组织中成纤维细胞内Ⅰ型前胶原mRNA相对表达量对照组(0.809±0.042)比实验组(0.540±0.026)增高。结论ADM能抑制切口中成纤维细胞的增生和胶原的过度分泌,减少瘢痕的形成。Objective ADM was prepared by NaOH-maceration. This study aimed to investigate the feasibility of the ADM inhibiting scar on the wound healing of SD rat and explore a modus operandi to prevent and cure the scar clinically. Methods ADM was prepared by the combination of 4% NaOH solution method. To establish the model of skin wound, each rat was operated full-thicknessly in skin on two sides of back after haemostasis completely. All the wounds were assigned to two groups, one group was treated by transplantation of ADM, the other was interrupted suture. On days 3, 5, 7, 14, 21, 28 and 63 after operation, the process of wound healing was observed to make post-operative evaluation, measure fibroblast and collagen content by HE and Masson staining, and measure the expression of type Ⅰ procollagen mRNA from fibroblasts in all specimens by RT-PCR. Results After operation, scar was not found in the ADM experimental group, while linear scarring was found in the control group obviously Under light microscopy, ADM was rebuilt as autologous tissue gradually in wound, and inflammatory cell, contents of fibroblasts （P 〈 0.05） and collagens （P 〈 0.01） were obviously less than controls. The epithelia and formation and thickness of the collagen looked like normal skin. And the expression of type Ⅰ procollagens mRNA from fibroblasts also decreased in ADM experimental group. Conclusions Treated as autologous tissue, ADM decreased exudations, inflammatory reaction, and inhibited hyperplasy of fibroblasts and synthesis of collagens. ADM demonstrated advantages in remodeling dermal tissue and reduced scar tissue to near normal as a therapeutic tool.

关 键 词：脱细胞真皮基质 切口愈合 瘢痕 成纤维细胞 

分 类 号：R622[医药卫生—整形外科]