真皮“生物模板”对创面愈合中胶原影响的研究

The Effect of Dermal Regeneration Template on Wound Collagen Synthesis

目的 探讨真皮“生物模板”对创面愈合中Ⅰ、Ⅲ型胶原含量和Ⅰ、Ⅲ型前胶原mRNA表达的影响。方法 采用真皮“生物模板”(同种异体无细胞真皮基质)加自体刃厚皮片复合移植的方法,修复深度烧伤病人切痂后创面,并以单纯自体刃厚皮片移植为对照,分别于术后1、2、3、4周取组织标本,共48例次,采用免疫组化、原位杂交技术和图像分析技术对组织标本中Ⅰ、Ⅲ型胶原的含量和Ⅰ、Ⅲ型前胶原mRNA的表达进行检测。结果 真皮“生物模板”移植术后1～4周,组织标本中Ⅰ型胶原含量逐渐增加,Ⅰ型前胶原mRNA表达第2、3周达到高峰,然后逐渐降低,真皮“生物模板”试验组和对照组两者之间无显著差异(P>0.05)。组织标本中Ⅲ型胶原含量,随着创面愈合,试验组明显减少,对照组则减少不明显(P<0.05);同时,试验组Ⅲ型前胶原mRNA的表达在术后1、2周达高峰,随后逐渐降低,而对照组Ⅲ型前胶原mRNA的表达一直在较高水平,且各时相点均高于试验组,两组差异明显(P<0.05)。结论 真皮“生物模板”通过减少创面局部Ⅲ型胶原的产生,减少和(或)减轻疤痕增生,改善愈合质量。

Objective To evaluate the wound collagen synthesis changes after the application of dermal regeneration template ( allogenic acellular dermal matrix). Methods Forty -eight eschar excised wounds of 36 deep burn patients were covered by dermal regeneration template with overlying thin split -thickness autograft. The control site received a split - thickness autograft alone. Wound specimens were examined for the level of collagen I and Ⅲ and the mRNA expression of procollagen I and Ⅲ by means of immunohistochemistry method and in situ hybridization method at 1st- 4th week post operation. Results During 1st-4th week wound healing there was no difference in the levels of collagen I and the mRNA expression of procollagen I in two groups(P >0. 05) ;but the levels of collagen Ⅲ and mRNA expression of procollagen Ⅲ in the dermal template transplantation group were significantly lower than those of the split - thickness skin grafts group ( P < 0. 05 ) . Conclusion In the wound healing process , dermal regeneration template could alleviate the formation of scar by reducing the synthesis of collagen Ⅲ.