上海交通大学学报(医学版)

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增生性瘢痕发生和演变过程中微血管和氧分压动态变化的研究

宋菲,刘英开,王西樵   

  1. 上海交通大学 医学院附属瑞金医院烧伤研究所上海 200025
  • 出版日期:2016-11-28 发布日期:2016-11-29
  • 通讯作者: 王西樵,电子信箱:wxqiao2002@hotmail.com。
  • 作者简介:宋菲(1981—),女,主管技师,学士。电子信箱:fayex3@126.com。
  • 基金资助:

    国家自然科学基金(81671914)

Study on dynamic changes in microvessels and partial pressure of oxygen during the occurrence and development of hypertrophic scars

SONG Fei, LIU Ying-kai, WANG Xi-qiao   

  1. Institute of Burn, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
  • Online:2016-11-28 Published:2016-11-29
  • Supported by:

    National Natural Science Foundation of China,81671914

摘要:

目的 ·探讨增生性瘢痕在发生和演变过程中,微血管和氧分压动态的变化。方法 ·选择人不同时期增生性瘢痕,分为早期、增生期、消退期和成熟期瘢痕,每组 8例。术前进行经皮氧分压检测,正常皮肤作对照。术后对瘢痕组织进行固定切片、 H-E染色,采用免疫组化进行 CD34和 HIF-1检测。结果采用两样本均数比较的 t检验对数据进行显著性分析。结果 ·经皮氧分压检测发现:与正常皮肤氧分压 [(75.3±10.1) mmHg]相比,瘢痕早期氧分压开始降低 [(51.2±8.3) mmHg P=0.037],增生期进一步降低 [(30.2±6.1) mmHg, P=0.026],消退期最低 [(6.9±2.1) mmHg,P=0.011],成熟期基本回复正常 [(71.1±9.6) mmHg P=0.080]。H-E染色发现:正常皮肤具少量微血管,瘢痕早期微血管逐渐增多,在增生期达到高峰,消退期大部分血管狭窄或闭塞,成熟期基本正常。CD34检测结果进一步证明微血管这种形态和数量的变化。 HIF-1检测发现:正常皮肤 HIF-1表达低,瘢痕早期显著升高,在增生期进一步升高,而在消退期则显著下降,成熟期几乎回复正常。结论 ·增生性瘢痕发生和演变过程中,微血管和氧分压存在动态改变,这种变化与瘢痕的病理改变相互关联,而HIF-1可能介导了其中的作用。

关键词: 增生性瘢痕, 微血管, 氧分压, HIF-1

Abstract:

Objective · To investigate dynamic changes in microvessels and partial pressure of oxygen during the occurrence and development of hypertrophic scars. Methods · Patients with early, hypertrophic, regressive, and mature scars were respectively assigned to four groups with 8 patients in one group. Partial pressure of oxygen was percutaneously measured before scar surgery with normal skin as the control. Scar tissues were fixed, sectioned, and H-E stained after surgery. CD34 and hypoxia inducible factor-1 (HIF-1) were measured with immunohistochemistry. Significance analysis was performed on results with two sample mean comparison test (t test). Results · Percutaneous measurement of partial pressure of oxygen found that compared with normal control [(75.3±10.1)mmHg], partial pressure of oxygen started to decrease in early scars [(51.2±8.3) mmHg,P=0.037], further decreased in hypertrophic scars [(30.2±6.1)mmHg,P=0.026], reached the lowest in regressive scars [(6.9±2.1)mmHg,P=0.011], and returned to normal in mature scars [(71.1±9.6) mmHg,P=0.080]. H-E staining revealed that there were a small amount of microvessels in normal skin. Microvessels gradually increased in early scars and reached the highest number in hypertrophic scars. Stenosis or occlusion occurred in most microvessels in regressive scars and microvessels returned to normal in mature scars. Results of CD34 examination further confirmed these changes in microvascular morphology and number. HIF-1 examination found that the HIF-1 expression was low in normal skin, significantly increased in early scars, further increased in hypertrophic scars, significantly decreased in regressive scars, and almost returned to normal in mature scars. Conclusion · There are dynamic changes in microvessels and partial pressure of oxygen during the occurrence and development of hypertrophic scars. These changes are associated with pathological changes in scars and may be mediated by HIF-1.

Key words: hypertrophic scar, microvessel, tissue oxygen tension, HIF-1