小肠黏膜下层与脱细胞羊膜促进大鼠损伤皮肤修复及血管形成的作用

The function of small intestinal submucosa and acellular amniotic in promotion reparation and vascularization of injured skin in rat

目的：探讨小肠黏膜下层及脱细胞羊膜在促进大鼠皮肤损伤修复和血管形成中的作用。方法取SD大鼠60只，于每只背部两侧各做一个1．5 cm ＆#215;1．5 cm大小全层皮肤缺损，至深筋膜。将大鼠随机分为3组，A组创面采用小肠黏膜下层细胞覆盖，B组创面以双层脱细胞羊膜覆盖，C组创面以等渗生理盐水纱布覆盖。观察各组创面愈合情况，在1-4周时将动物处死并取材，HE染色下观察并计数炎症细胞数，免疫组化SP法染色下观察血管内皮细胞数目。结果1周时，与C组相比，A、B组敷料与缺损创面贴合紧密，与纱布无粘连，更换敷料时创面无渗血。各时间点，A、B组创面组织内炎症因子数均明显低于C组（ P均＜0．05），而A组与B组比较差异无统计学意义（P＞0．05）。1-3周时，A、B组血管内皮细胞数明显高于C组（P均＜0．05），而A组与B组比较差异无统计学意义（P＞0．05）。结论应用小肠黏膜下层细胞及及脱细胞羊膜来覆盖皮肤缺损创面，均可减少创面的出血及渗出，减轻局部炎症反应，促进内皮细胞增殖及新生血管形成，具有加快创面愈合的作用。

Objective It is to approach the function of small intestinal submucosa and acellular amniotic in promotion rep-aration and vascularization of injured skin in rat.Methods Two full-thickness skin defects that about 1.5 cm ＆#215;1.5 cm were created on both sides of the dorsum of the 60 SD rats.Then the animals were randomly divided into 3 groups.The skin defects was covered by the small intestinal submucosa in Group A, by acellular amniotic membrane in Group B and by physiological saline gauze in group C.The wound healing condition was observed in all groups.After 1-4 weeks, the sample was harvested for histological evaluation.Results Compared with group C at 1 week, the other two groups had a more tightly wound adher-ence, and with little bleeding when change the dressing （P〈0.05）.At each time point, Group A and B had a lower level in-flammatory cytokines and a higher vascular endothelial cells than Group C （all P〈0.05）.However, there was no significant difference between Group A and B（P〉0.05）.Conclusion The small intestinal submucosa and acellular amniotic can improve the wound healing rate, reduce the inflammation and promote endothelial cells proliferation and angiogenesis.