肉毒毒素与透明质酸联合应用对皮肤真皮层成纤维细胞增长和胶原沉积的影响

Effects of both botulinum toxin type A and hyaluronie acid on fibroblastic proliferation and collagen dep-osition in dermal layer

目的探讨肉毒毒素与透明质酸联合应用对皮肤真皮层成纤维细胞增长和胶原沉积的影响。方法实验采用新西兰兔建立动物模型，设立透明质酸（HA实验组）、A型肉毒毒素（BTX—A实验组）及二者联合（联合实验组），注射3个实验组和对照组（生理盐水），于第1、2、4周．通过病理切片HE染色，规察各实验组对真皮层成纤维细胞影响的差异，用Ⅰ、Ⅱ型胶原免疫组织化学染色方法。评估各实验组对真皮层胶原含量影响的差异。结果联合实验组第2、4周成纤维细胞数日娩著高于对照组（P〈0．05），免疫组织化学切片Ⅰ、Ⅲ型胶原平均积分吸光度（A值）与对照组差异无统计学意义（P〉0．05）。结论BTX—A和HA联合局部注射使真皮层成纤维细胞数目增加，且有效缓解BTX—A单独注射引起的对Ⅰ、Ⅲ型胶原沉积的抑制作用，从而提高肉毒毒素和透明质酸单独应用的治疗效果。

Objective To study the effect on fibroblastie proliferation and collagen deposition in dermal layer with combined treatment of botulinum toxin type A （BTX-A） and hyaluronie acid （HA）. Methods Six male New Zealand rabbits were selected to establish animal models and subcutaneous separated injections were carried out with saline （control group）, HA （HA group）, BTX-A （BTX A group） and combination treatment of BTX-A and HA （combination group）. The observation of differ-ences between these four treatment groups was conducted on day 7, day 14, and day 28 respectively after the experimental treatment, including the number and morphology of fibroblasts with HE stai-ning and the deposition of type ~ and type HI collagen with immunohistochemieal staining under light microscope. Results The group with combined treatment of BTX-A and HA had significantly larger number of fibroblasts at all the three observation time points （P〈0.05）. In terms of average IOD from immunohistoehemical stained section of production of type Ⅰ and type Ⅲ collagen, the group with combined treatment exerted no significant differences as compared to the control group （P〉0.05）. Conclusions The combined treatment of BTX-A and HA will promote the proliferation of fi-broblasts and to some degree offset its inhibitory effect on production of collagen. The combination will improve the efficacy of any separated treatment with BTX A or HA.