曲安奈德抑制兔耳瘢痕增生与氧自由基作用的初步研究  

Preliminary research on the relationship between inhibitory effect of Triamcinolone Acetonide on hypertrophic scar and oxygen free radicals in rabbits

作　　者：陈鑫[1] 李伟人[1] 孔豫苏[1] 王伟[1] 

机构地区：[1]贵州贵阳医学院附属医院烧伤整形科,贵阳550004

出　　处：《中华整形外科杂志》2010年第6期440-443,共4页Chinese Journal of Plastic Surgery

基　　金：贵州省科技厅基金（黔科合J字（2006））2062号）,贵医附院博士基金

摘　　要：目的 了解曲安奈德局部注射对兔耳增生性瘢痕组织中丙二醛含量的影响,并探讨曲安奈德抑制兔耳增生性瘢痕的作用与氧自由基的关系. 方法 新西兰兔共18只,随机选取其中的14只制作兔耳增生性瘢痕模型,4只作为正常兔耳皮肤组织标本,共8例;兔耳增生性瘢痕组织标本28例,随机分为曲安奈德组（10例）、生理盐水组（10例）、空白对照组（8例）.制模术后6周予曲安奈德原液（1 ml：40 mg）分点注射于瘢痕样组织内,每处2～3点,总量0.3～0.4 ml,每周1次,3次为一疗程.制模术后9周取材,显微镜下记数成纤维细胞,并用测微尺测量瘢痕的相对增生厚度,以计算瘢痕增生指数,采用分光光度法测定丙二醛含量变化. 结果 ①大体形态学变化：曲安奈德局部治疗3周后,瘢痕颜色接近兔耳的正常肤色,略高出皮面,表面平整,触之质软.②组织学变化：与空白对照组、生理盐水组比较,曲安奈德组胶原纤维多为平行排列,数量减少.③成纤维细胞密度与瘢痕增生指数变化：与正常皮肤组比较,空白对照组以及生理盐水组成纤维细胞密度增高（P＜0.05）,而曲安奈德组则无显著性差异（P＞0.05）;生理盐水组与空白对照组间成纤维细胞密度及瘢痕增生指数比较差异无统计学意义（P＞0.05）,与此两组比较,曲安奈德组则显著降低（P＜0.05）.④丙二醛含量变化：与空白对照组、生理盐水组、正常皮肤组比较,曲安奈德组丙二醛含量明显增高（P＜0.05）;生理盐水组与空白对照组间比较差异无统计学意义（P＞0.05）;与正常皮肤组比较,空白对照组和生理盐水组丙二醛含量增高（P＜0.05）. 结论 曲安奈德局部注射引起兔耳增生性瘢痕组织中氧自由基水平进一步升高.Objective To investigate the relationship between inhibitory effect of triamcinolone acetonide（TA）on hypertrophic scar and oxygen free radicals in rabbits. Methods 18 New Zealand rabbits were used.14 rabbits were selected randomly to construct animal models of hypertrophic scar on the ears.Another 4 rabbits（8 ears）were used as controls.6 weeks after operation,the hypertrophic scar on the ears were randomly divided to receive intra-lesion injection of TA（n = 10）,or normal saline（n = 10）,or nothing（n = 8,sham group）.9 weeks after operation,scar specimens were taken for scar thickness measurement,fibroblast counting under microscopy and MDA content detection by spectrophotometric method. Results ① 3 weeks after TA treatment,the scar became very thin and soft with a similar color to normal skin and a smooth surface;② Histologic study showed the collagen fibers in TA group were reduced markedly and arranged parallelly;③ Compared with normal skin,the fibroblast density in sham and saline groups increased significantly（P〈0.05）,while it was not markedly different in TA group（P〉 0.05）.There was also no significant difference in scar hypertrophic index between sham and saline groups（P 〉 0.05）,but the scar hypertrophic index was decreased dramatically in TA group（P〈0.05）;④ The MDA content was highest in TA group（P〈0.05）,followed by that in sham and saline groups（P 〈 0.05）,while there was no difference between these two groups（P 〉 0.05）.It was lowest in normal control group（P〈0.05）. Conclusions The oxygen free radicals in the hypertrophic scar can be further increased by local injection of TA.

关 键 词：增生性瘢痕 曲安奈德 氧自由基 细胞凋亡 成纤维细胞 

分 类 号：R764[医药卫生—耳鼻咽喉科] R622[医药卫生—临床医学]