电损伤与烧伤皮肤上皮细胞极性化改变的研究

Polarized change of epithelia of skin on electrical injury and burn

目的:探讨电损伤、热烧伤皮肤上皮细胞极性化改变的机制,并为其诊断提供客观量化指标。方法:对380V交流电组、220V交流电组、220V直流电组、火焰烧伤组、金属灼伤组及正常对照组进行HE染色、EGFR染色及透射电镜观察,图像分析系统测定极性化上皮细胞核周长、长径、短径及长/短径比值,并进行统计学分析。结果:电损伤与热烧伤上皮细胞超微结构改变一致;极性化上皮细胞与正常上皮细胞EGFR在胞浆内分布较均匀;各损伤组皮肤上皮细胞核变长;各电损伤组上皮细胞核周长及长/短径比值两两比较无显著性差异(P>0.05);2组热烧伤组比较也无显著性差异(P>0.05);而各电损伤组分别与各热烧伤组比较有显著性差异(P<0.05)。结论:电、热损伤上皮细胞极性化改变主要系热效应作用所致;定量测定损伤皮肤上皮细胞核周长及核长/短径比值,可推断该损伤系低压电损伤或烧伤。

Objective：To study the mechanism of epithelium polarized change of skin on electrical injury and burn and provide an objective and quantitative index on them.Methods：Specimens including 380V alternating current（AC）,220V AC,220V direct current（DC）,flame burn,hot metal burn and the control group are dyed with hematoxylion-eosin,immunohistochemically examined with antibody against EGFR,and observed with transmission electron microscopy,respectively.Circumference,long axis,short axis and long /short axis ratio of the polarized epithelia nuclei were also measured by computerized image analysis and calculated.Results：There are homogeneous on ultrastructure among injured groups.Immunohistochemical staining with EGFR showed positive and uniform staining in injured and normal skin.Epithelia Nuclei of skin on all injured groups are elongated.By measuring the circumference and the long/short axis ratio of epithelia,there were no significant differences among three electrically injured groups（P〉0.05）.The same conclusion was also obtained between the flame burned group and hot metal burned group（P〉0.05）.But there were obvious differences between each electrically injured groups and each burned groups（P〈0.05）.Conclusion：Epithelium polarized change of skin on electrical injury and burned skin is mainly resulted from thermal effect.The circumference and the long/short axis ratio of polarized epithelia nuclei of injured skin may be used to differentiate lowvoltage electrical injury from burn.