深度烧伤后增生性瘢痕和瘢痕疙瘩中神经再生的研究

Nerve Regeneration of Hypertrophic Scars and Keloids after Deep Burns

目的了解人类深度烧伤后增生性瘢痕和瘢痕疙瘩中神经再生的状况.方法对57例临床和病理诊断均为增生性瘢痕和瘢痕疙瘩的深度烧伤患者的瘢痕组织进行免疫组化LSAB法双标染色,通过图像采集分析系统测定S-100和神经微丝蛋白(NF)的平均积分光密度值(MIOD).结果随着时间推移,增生性瘢痕组与瘢痕疙瘩组神经再生逐渐增加,在伤后3～5月时间段内增长的速率较大,至18月以后,增生速率逐渐变小,其S-100和NF的表达,在伤后各时间段相比较,差异有统计学意义(P<0.05);增生性瘢痕组S-100和NF的表达在各时间段均高于瘢痕疙瘩组,但在3～5月时间段内差异无统计学意义,在6月及以上时间段内差异有统计学意义.结论 S-100与NF能准确反映病理性瘢痕中神经再生情况.深度烧伤后病理性瘢痕中的神经再生随时间变化而变化,且增生性瘢痕中神经的再生多于瘢痕疙瘩.

Objective To disclose whether there is difference in nerve regeneration between human hypertrophic scars and keloids after deep burns so as to provide a basis for new clinical treatment. Methods Fifty-seven samples that were clinically and pathologically diagnosed as hypertrophic scars or keloicls after deep burns were examined by use of two-label immunohistochemistry to define the nerves in scars. Then, the Mean Integrated Optical Density （MIOD） of S-100 and the MIOD of neurofilament （NF） proteins were measured and analyzed. Results In hypertrophic scars or keloids, the nerve regeneration was growing gradually. The speed was high 3-5 months after burn and it slowed clown 18 months after burn. The expression of S-100and NF varied with different period of time （P〈0.05）. The expression of S-100 and NF in hypertrophic scars was higher than that in keloids. There was no difference 3-5 months after burn, but there was difference 6 months after burn. Conclusion S-100 and NF are good markers to define the nerve regeneration in scars. The nerve regeneration in hypertrophic scars or keloids changes with the times. The nerve regeneration is more conspicuous in hypertrophic scars than in keloids.