摘要
目的：研究肥厚性瘢痕中胶原累积和清除两方面的相对关系。方法：实验方法有临床观察、动物模型和细胞培养。观察方法有：光镜与电镜、组织化学、原位杂交、斑点杂交等等。结果：①肥厚性瘢痕的自然形成极慢，而用药物干预可以在一个月以内使其消退１／３～２／３。②肥厚性瘢痕中的胶原合成速度有所增加，但其降解速度减慢更为显著。③肥厚性瘢痕中胶原酶的表达有所增加，但其实际生成量和活性则为降低。④肥厚性瘢痕中Ｃｈ－４－Ｓ明显增加，一方面包绕胶原纤维，阻碍胶原酶的接触和降解作用，另一方面也通过ＴＩＭＰ降低胶原酶的活性。⑤肥厚性瘢痕中ＴＩＭＰ增加，降低胶原酶的活性。⑥肥厚性瘢痕中ＴＧＢ－β显著增加，其表达量与ＴＩＭＰ表达成正相关，与凋亡细胞数成负相关。ＴＧＦ－β使ＭＭＰ－１表达减少，活性下降。⑦肥厚性瘢痕中的成纤维细胞绝大多数为肌成纤维细胞，增殖期凋亡极少，成熟期显著增多。结论：①肥厚性瘢痕中成纤维细胞凋亡减缓和胶原酶数量和活性降低，胶原被Ｃｈ－４－Ｓ包绕而降解减慢，以致胶原累积，是肥厚性瘢痕形成的主要方面。
Purpose: To understand the function of
catabolism
degradation in the formation and deterioration of hypertrophic scar. Method: The study was
carried out clinically, on animal model and cultured fibroblast cell. The investigation was
conducted with naked eye, microscope, situ hybridization, dot blot hybridization, TUNEL and
immunohistochemistry. Result:①The hypertrophic scar grew up very slow but might be
eliminated 1/3 to 2/3 within one month with different chemical intervention. ②The synthesis of
collagen in hypertrophic scar increased a little, but it's degradation decreased much more. ③
The collagenase MMP 1 could destroy the collagen after local injection into the hypertrophic
scar, it was proved by light and electromicroscope. ④The expression of MMP 1 mRNA
increased a little in hypertrophic scar, but MMP 1 in the scar really decreased in quantity and
activity. ⑤Ch 4 S increased significantly in hypertrophic scar, it wrapped up the collagen
fibrils and blocked its contact with and avoided its catabolism by MMP 1.TIMP increased in
hypertrophic scar and depressed the activity of MMP 1. ⑦The expression of TGF β increased
significantly. It positively related with the expression of TIMP and negatively related with the
apototic phenomena in hypertrophic scar. The fibroblast in hypertrophic scar was rich and
active, but its proliferation was not elevated and apotosis was delayed. Conclusion: ①The
delay of apotosis of fibroblast, the wrapping of collagen by Ch 4 S, the reduction of
collagenase in quantity and activity together made the abolition of collagen decreased and
might be primary for the formation of hypertrophic scar. ②Accelerating the apotosis of fibroblast
and catabolism of collagen might be an easy and rapid way for prevention and treatment of
hypertrophic scar.
出处
《中国康复理论与实践》
CSCD
1999年第1期6-8,共3页
Chinese Journal of Rehabilitation Theory and Practice
关键词
肥厚性瘢痕
胶原
降解
康复
烧伤
hypertrophic scar
collagen
catabolism degradation
