复合皮真皮-表皮连接区结构再生与功能重建  

Structural restoration and functional reformation in dermal-epidermal junction zone of composite skin

作　　者：姜笃银[1] 陈璧[1] 胡大海[1] 汤朝武[1] 史颖辉[2] 

机构地区：[1]第四军医大学西京医院烧伤外科,西安710033 [2]第四军医大学基础部电镜中心,西安710033

出　　处：《临床与实验病理学杂志》2000年第5期397-400,共4页Chinese Journal of Clinical and Experimental Pathology

基　　金：国家自然科学基金资助项目 !(No 3 90 70 82 2 )

摘　　要：目的 :为了解复合皮 (CS)真皮 表皮连接 (DEJ)区结构再生及其对CS功能重建的作用机制。方法 :用经胰蛋白酶处理的异体乳猪真皮与自体表皮重组CS ,并以自体表皮为对照 (C组 ) ,对移植术后 2～ 12 4周的活检标本作光镜和透射电镜观察。　结果 :①CS组表皮和真皮生长快、成熟早 ,乳头层组织疏松有序 ,毛细血管增生迅速 ,2 0～ 2 4周时 ,乳头和皮钉及以致密板为中心的半桥粒、锚丝、锚纤维等DEJ区结构形成 ,以靠近毛细血管部位的上述结构再生迅速而密集 ;②C组早期水泡发生率高 (P <0 0 5 ) ,DEJ区缺乏锚丝和锚纤维 ;至 48周时上述结构稀疏而不典型。结论 :CS有较好的外观、抗挛缩和耐磨功能与DEJ区结构再生密切相关 ,异体乳猪真皮具有引导血管再生和正常化作用 。Purpose To investigate the mechanism of structure reformation in dermal epidermal junction(DEJ) zone of composite skin(CS) with allogeneic newborn pig dermis and its significance to functional restoration of CS. Methods Biopsied specimens from experimental group using CS made of trypsin treated frozen allogeneic newborn pig dermis and autologous epidermis(group CS) and control group using autologous epidermis alone (group C) respectively,were observed and compared under the light microscope and transmission electron microscope during the weeks 2 to 124 after graft operation. Results The epidermis and dermis grew faster and matured earlier with loose and regular tissue structure and rapid rate of angiogenesis in papillary layer in the groups CS. By weeks 20 to 24 after graft operation,the reformation of papillae,dermal ridges and half desmosomes,anchoring filaments and anchoring fibers converging around the dense laminae appeared in DEJ zone of group CS occurred with performing more rapidly and densely near the new microvessels. There was a higher incidence of blister in the early stage in the group C( P< 0 05),without reformation of anchoring filaments or anchoring fibers which appeared scattering and untypical in DEJ zone until week 48 postoperation. Conclusion The characteristics of the CS,such as good looking appearance,anti contracture and tolerance to abrasive force,might closely relate to the structural reformation of DEJ zone. Allogeneic newborn pig dermis could improve the angiogenesis and remodeling of new blood vessels and subsequently accelerate the structural and functional reformation of DEJ zone.

关 键 词：复合皮 真皮-表皮连接 皮肤移植 功能重建 

分 类 号：R622.1[医药卫生—整形外科]