不同厚度自体皮片移植对大鼠深Ⅱ°烧伤创面成纤维细胞转化的影响  

Effect of skin autograft with different thickness on the transdifferentiation of fibroblasts after deep partial thickness burn in rats

作　　者：马恬[1] 贾赤宇 焦大凯[3] 

机构地区：[1]解放军总医院整形科军医进修学院,北京100853 [2]解放军第三○九医院整形美容烧伤修复中心 [3]航空工业中心医院整形科

出　　处：《中华医学杂志》2011年第14期1000-1003,共4页National Medical Journal of China

基　　金：国家自然科学基金（30772259）

摘　　要：目的 探讨自体刃厚皮、中厚皮及全厚皮覆盖SD大鼠深Ⅱ°烧伤创面对创基成纤维细胞向肌成纤维细胞转化的影响.方法 将40只SD大鼠随机平均分为A、B两组,每组每只大鼠制作10%体表面积的深Ⅱ°烧伤模型,伤后即刻削痂并采用自体刃厚皮、中厚皮及全厚皮覆盖创面,同体相同对照创面伤后不做任何覆盖,A组于植皮后48 h取材,B组于植皮后7 d取材.用免疫组化方法观察不同创基中α-平滑肌肌动蛋白（α-SMA）表达情况,定量检测肌成纤维细胞（α-SMA阳性细胞）和成纤维细胞（α-SMA阴性细胞）的数量,计算肌成纤维细胞转化率.结果 植皮后48 h取材组对照创面、刃厚皮移植创面、中厚皮移植创面和全厚皮移植创面创基肌成纤维细胞的转化率分别为（76.3±3.3）%、（69.8±1.6）%、（57.5±1.6）%、（44.7±1.7）%;植皮后7 d取材组上述4种创面创基肌成纤维细胞的转化率分别为（72.9±6.1）%、（63.6±4.7）%、（50.2±1.6）%、（32.3±1.2）%.对照创面创基肌成纤维细胞转化率均高于各实验创面（均P＜0.01）;刃厚皮、中厚皮及全厚皮移植创面两两比较,创基肌成纤维细胞转化率差异均有统计学意义（均P＜0.05）.结论 SD大鼠深Ⅱ°烧伤创面成纤维细胞向肌成纤维细胞转化率与其创面的覆盖方式直接相关,这可能对远期瘢痕收缩的程度有直接影响.Objective To investigate the effect of thin split-thickness skin, inter-mediate thickness skin and full-thickness skin autograft on the differentiation of fibroblasts into myofibroblasts in rats after deep partial thickness burn. Methods A total of 40 SD rats were divided randomly into two groups （Group A ＆ Group B, n =20 each）. In Group A, tissue samples were collected at Day 2 after skin-grafting while Day 7in Group B. In each group, every rat was scalded to cause deep partial thickness wound with an area of 10% of total body surface. The wounds received eschar shaving instantly coupled with skin-autograft, covering with thin split-thickness skin, inter-mediate thickness skin and full-thickness skin respectively. Meanwhile the control wound on the same rat was scalded only. Then the expression of α-SMA was detected by immunohistochemistry in each wound. And the numbers of myofibroblasts （α-SMA positive cells ） and fibroblasts （negative cells） were counted to calculate the conversion ratio of myofibroblasts. Results In Group A, the conversion ratios of myofibroblasts of control, thin split-thickness skin autograft, inter-mediate thickness skin and full-thickness skin groups were （76. 3 ±3. 3）%, （69. 8 ± 1.6）%, （57.5 ± 1.6）% and （44. 7 ± 1.7 ） % respectively. In Group B, the ratios were （72. 9 ± 6. 1 ） %, （ 63.6 ± 4. 7 ） %, （ 50. 2 ±1.6）% and （32. 3 ± 1.2）% respectively. The ratio was higher in control group than that in any other one （P ＜0. 01 ）. There was statistic difference between thin split-thickness skin, inter-mediate thickness skin and full-thickness skin autograft groups （ P ＜ 0. 05 ）. Conclusion A direct association may exist between the conversion ratio of myofibroblasts and the application of skin-grafting in rats after deep partial thickness scalding. It is probably related with varying degrees of scar contracture in the long-term.

关 键 词：烧伤 皮肤移植 成纤维细胞 

分 类 号：R644[医药卫生—外科学]