人指及趾皮肤触觉小体的比较研究与临床意义

The study and clinical significance of comparison of Meissner corpuscle number in fingers and toes

目的:研究手指指腹、手掌、手背、前臂内侧、足趾趾腹各部位皮肤中触觉小体的分布和数量,探讨其在手部皮肤缺损修复中的临床意义。方法:从临床和解剖室尸体收集各部位正常人皮肤标本共99例,分别做石蜡切片,以S-100特异性抗体免疫组化染色,光镜下观察触觉小体形态与分布,计算机显微图像摄影与分析系统检测各标本触觉小体数量(以个/mm表示)。SPSS17.0统计分析各部位触觉小体数量及差异。结果:光镜下各部位触觉小体形态相似,均集中位于真皮乳头层内。手指指腹触觉小体数量为(0.43±0.30)个/mm,手掌为(0.20±0.15)个/mm,手背为(0.11±0.12)个/mm、前臂内侧为(0.03±0.06)个/mm、趾腹为(0.34±0.28)个/mm。手指指腹与足趾趾腹间触觉小体数量差异无显著性(P>0.05),与手掌、手背、前臂内侧间触觉小体数量差异有显著性(P<0.01)。足趾趾腹与手掌间触觉小体数量差异无显著性(P>0.05),与手背、前臂内侧间触觉小体数量差异有显著性(P<0.05)。手掌、手背、前臂内侧三者间触觉小体数量差异无显著性(P>0.05)。结论:人手指指腹、手掌、手背、前臂内侧、足趾趾腹各部位皮肤中触觉小体形态与分布相近,手指指腹中触觉小体数量最丰富。手指指腹、手掌与足趾趾腹部位触觉小体数量最相近。对于手指、手掌部位的皮肤缺损,足趾是较手背、前臂内侧更为理想的供区。

Objective To study the distribution and number of Meissner corpuscles in finger pulp, palm of hand, dorsum of hand, forearm and toes, and explore their clinical application in hands defect repairing. Methods 99 normal skin specimens were collected from amputated extremities and cadavers, and the specimen paraffin sections were immunostained with S-100 protein. The morphous of Meissner corpuscles was observed and the number was quantified by the light microscope examination and analysis system, and the data was analyzed by SPSS17.0 statistical software. Results Meissner corpuscles, which similar in morphology, are all in papillary bayer of dermis. The mean Meissner corpuscle number is （0.43＋0.30）/mm in finger pulp, （0.20＋0.15）/mm in palm of hand, （0.11＋0.12）/mm in dosum of hand, （0.03_＋0.06）/mm in forearm, and （0.34＋0.2）/mm in toes. The Meissner corpuscle number of finger pulp is not significant different with that of toes （P〉0.05）, while is significant different with that of palm of hand, dosum of hand and forearm （P〈0.01）. The Meissner corpuscle number of toes is not significant different with that of palm of hand （P〉0.05）, while is significant different with that of dosum of hand and forearm （P〈0.05）. No significant difference of Meissner corpuscle number was found among palm of hand, dosum of hand and forearm. Conclusion The morphous and distribution of the meissner corpuscle in finger pulp, palm of hand, dorsum of hand, forearm and toes are similar, and the meissner corpuscle in finger pulp is more redundant than the other 4 sites. The Meissner corpuscle number of finger pulp and palm of hand is more closed to toes than that of dosum of hand and forearm. The toes possiblely is an more ideal donor site for the repairing of fingers and palms skin defet.