摘要
为探讨烧伤深Ⅱ度创面早期加深及其愈合与纤溶功能变化的关系,观察了深Ⅱ度烫伤大鼠伤后10天内创面组织学和纤溶反应的变化。Masson 胶原染色显示创面在伤后72小时内逐步加深,伤后10天见新生结缔组织和创缘表皮增殖匍行。对血浆和创面活检组织24小时浸出液中纤溶指标的测试表明伤后2小时创面纤溶反应激活,但在伤后24小时已呈抑制状态,并持续至伤后10天。纤溶指标动态变化和相关性分析提示纤溶抑制因素可能来自伤后早期活性即已显著增强的创面纤溶酶原激活抑制物,伤后24小时起活性显著增强的α_2抗纤溶酶,以及伤后72小时活性显著增强的抗凝血酶Ⅲ。观察结果提示烫伤后纤溶功能抑制可使创面局部的纤维蛋白不致溶解,从而成为深Ⅱ度创面早期加深的一个重要因素,也可能是创面愈合调控中的一个重要环节。
We observed the changes in wound histopathology and fibrinolysis of rats with deep par- tial thickness burns during 10 days after scalding in order to study the relations of early progressive damage of deep partial thickness burn wound and the healing of the wound to fibrinolysis. Using Masson's trichrome stain of collagen,we demonstrated that partial thickness burn wound progressively deteriorated within 72 hours postburn,and epidermal ceils on wound edge proliferated,creeping be- tween necrotic and residual collagen by 10th day postburn.The results of assays of fibrinolytic parame- ters in plasma and 24 hour exudate from wound showed that fibrinolysis activated at 2 hour postburn but had been suppressed by 24 hour postburn till last day(10 day postburn)of the observation.The analysis of dynmaic changes and relations in fibrinolytic parameters revealed that the suppressive factors of fibrinolysis might be enhanced activites of PAl,α2-antiplasmin and antithrombin Ⅲ after injury.Re- suits suggested that suppression of fibrinolysis might protect fibrin deposited in the wound from lysis and play an important role in early progressive deterioration of deep partial thickness burn and regula- tion of its healing.
