外源性透明质酸应用于伤口愈合中的组织学观察

A histological study in wound healing with exogenous hyaluronic acid

目的：探讨外源性透明质酸（Ｈｙａｌｕｒｏｎｉｃａｃｉｄ，ＨＡ）在伤口愈合中可能的作用机制以及对瘢痕形成的影响。方法：大鼠４５只，随机分成Ａ、Ｂ、Ｃ（２％、１％ＨＡ、ＰＢＳ）３组，观察愈合过程中创面平均愈合时间和残留面积的大小、大体形态和组织学的改变。结果：（１）Ａ、Ｂ、Ｃ３组的平均愈合时间为１５．２，１４．２和１３．４ｄ。Ａ、Ｂ两组残留面积与Ｃ组比较有显著性差异，３组间比较也有显著性差异（Ｐ＜０．０１）。（２）组织学上，Ａ、Ｂ两组成纤维细胞增生明显，胶原纤维较为纤细、排列整齐，直径较纤细。Ｃ组则显示出明显的炎性细胞浸润，新生血管数目增多。（３）ＨＡ的生物学作用与其浓度有关。结论：在伤口愈合过程中，外源性ＨＡ可通过细胞的调控作用有效地发挥其生物学作用。

Objective: To evaluate the effects of exogenous hyaluronic acid(HA) on wound healing in a model of incised wound of rat skin and their possible mechanisms. Methods: The rats were randomly divided into three groups which were treated with 1% and 2% HA solution, and PBS as control. Wound areas were measured and mean wound healing time were calculated. Samples of the repaired tissue from wounds were harvested for study by light and transmission electronic microscopy. Results: (1) Wound areas were much smaller in control group than those in HAtreated groups, and the mean value of wound healing time was 15.2, 14.2 and 13.4 d.(2) Histologically, when compared qualitatively with PBS control, HAtreated wounds exhibited a less inflammatory response and angiogenesis, the fibroblast proliferated significantly, and the collagen fibrils were slender and arrayed in good order. (3) Meantime, it was found the result of treatment was correlated to the concentration of HA, i.e., its efficacy presented a dosedependent manner. Conclusion: The study indicated that the exogenous HA could effectively inhibit collagen synthesis and improve scar quality in wound healing by its physiological function.