皮肤扩张移植后组织学实验研究  

Experimental study on histomorphological changes of expanded skin after transplantation in dogs

作　　者：谢锋[1] 张正文[1] 马腾霄[1] 侴海燕[1] 李昊[1] 康深松[1] 

机构地区：[1]河南省人民医院整形外科,郑州450003

出　　处：《中华实验外科杂志》2014年第3期529-531,共3页Chinese Journal of Experimental Surgery

摘　　要：目的 观察扩张皮肤移植后的变化,探讨扩张皮肤远期回缩的机制.方法 选用8条普通成年犬,在每条犬背部设计4个解剖部位相对应的皮瓣下置入扩张器,注水8周后行扩张器取出术,随机将8条犬分为4组,每组2只,在犬皮肤扩张移植时和移植后3、6周及3、6个月检测其组织学、电镜变化及α-平滑肌肌动蛋白（αt-SMA） mRNA和蛋白的表达.结果 表皮层和真皮层移植后6个月基本恢复正常;电镜下可见扩张后表皮细胞排列紧密,真皮层于扩张后成纤维细胞数量较多,功能活跃,真皮深层有肌成纤维细胞存在,其胞质内微丝明显.移植后3个月成纤维细胞功能恢复正常,胶原排列趋于整齐,肌成纤维细胞消失,组织学在3～6个月时恢复到对照组水平.α-SMA mRNA和蛋白水平的表达在3周后达到最高,分别为1.204 ±0.011和1.533 ±0.012,3个月时明显降低为0.910±0.008和0.519±0.007,差异有统计学意义（P＜0.05）,α-SMA mRNA和蛋白水平变化趋势一致.结论 扩张皮肤的组织学变化在移植后6个月逐渐恢复正常,扩张皮肤远期回缩的机制可能与扩张皮肤内的肌成纤维细胞数量和功能状态有关.Objective To investigate the biological changes after transplantation of expanded skin and discuss the mechanism of skin retraction for further improving the clinical efficacy.Methods Eight adult dogs were used.On the back of each animal,4 rectangular expanders were implanted beneath the skin and panniculus carnosus bilaterally.Final injection was terminated through weekly injection over an 8-week period.Dogs were divided into 4 groups （n =2 each）.At 3rd week,6th week,3rd month and 6th month after inset of the flaps respectively,the skin-flap area was measured with histological examination stained with hematoxylin and eosin （HE）,ultrastructural observation under transmission electron microscope,and the expression level of α-smooth muscle actin （α-SMA） mRNA and protein.Results The epidermis and dermis of expanded flap returned to normal 6 months after the flap inset.The ultrastructural study revealed the following changes.In the epidermis,the intracellular spaces in all layers of expanded epidermis were significantly reduced.The expanded dermis contained large bundles of compacted collagen fibers which lined in disordering fibroblasts.A few myofibroblasts were seen in deeper part of the dermis.Three months post-inset,the fibroblasts functioned normally.Collagens lined themselves regularly and myofibroblasts disappeared.The α-SMA mRNA expression in skin expansion was significant between high expression （1.204 ± 0.011） at 3rd week and low expression （0.910 ± 0.008） at 3rd month.The expression of protein was same between （1.533 ±0.012） at 3rd week and （0.519 ±0.007） at 3rd month.The change trend of α-SMA mRNA and protein was consistent （P ＜ 0.05）.Conclusion The changes after skin expansion returned to normal after 6 months,expanded skin had certain degree of contraction after transplantation,which may be related to the appearance and persistence of myofibroblasts in dermis.

关 键 词：皮肤 组织扩张术 肌成纤维细胞 组织学 

分 类 号：R622[医药卫生—整形外科]