CAJ | 학술논문

目的观察阶梯比例自体微粒皮与异体脱细胞微粒真皮混合移植后创面的修复效果。方法选雄性Wistar大鼠为移植供体,以60只雌性SD大鼠作为受体,制作全层皮肤创面,并按混合的比例不同分为混合皮A、B、C组、自体皮组(D组)、异体皮组(E组),移植扩张比为5:1。比较各组创而愈合率,微血管计数及基质金属蛋白酶(MMP)-1和MMP-2蛋白表达。结果 (1)移植后2、3周,混合皮组创面愈合效果明显高于D组和E组,混合皮组间B、C组创面愈合率(28.94±2.97)％、(30.62±1.94)％;(81.14±9.30)％、(88.00±5.71)％显著高于A组(28.36±2.11)％;(79.81±7.07)％ (P ＜0.05),而且A组有明显脱屑现象。(2)移植后2、3周,混合皮各组微血管数目明显高于D组、E组(P＜0.05);移植后2周混合皮组间A组微血管数目(30.00±1.83)明显少于B、C组( 34.30±1.70)、(35.10±1.79)。(3)MMP-1在创面形成后表达上调,而后下降,但混合皮组MMP-1的表达高于D组,尤以A、B组明显;MMP-2在移植后第3周达高峰,混合皮组表达高于D组(P＜0.05)。结论自体微粒皮与异体脱细胞微粒真皮移植扩张比为4:1时,达到促进创面愈合的最佳比例,有利于微血管长入及MMP-1、2的适度表达。
목적 관찰계제비례자체미립피여이체탈세포미립진피혼합이식후창면적수복효과。방법 선웅성Wistar대서위이식공체,이60지자성SD대서작위수체,제작전층피부창면,병안혼합적비례불동분위혼합피A、B、C조、자체피조(D조)、이체피조(E조),이식확장비위5:1。비교각조창이유합솔,미혈관계수급기질금속단백매(MMP)-1화MMP-2단백표체。결과 (1)이식후2、3주,혼합피조창면유합효과명현고우D조화E조,혼합피조간B、C조창면유합솔(28.94±2.97)％、(30.62±1.94)％;(81.14±9.30)％、(88.00±5.71)％현저고우A조(28.36±2.11)％;(79.81±7.07)％ (P ＜0.05),이차A조유명현탈설현상。(2)이식후2、3주,혼합피각조미혈관수목명현고우D조、E조(P＜0.05);이식후2주혼합피조간A조미혈관수목(30.00±1.83)명현소우B、C조( 34.30±1.70)、(35.10±1.79)。(3)MMP-1재창면형성후표체상조,이후하강,단혼합피조MMP-1적표체고우D조,우이A、B조명현;MMP-2재이식후제3주체고봉,혼합피조표체고우D조(P＜0.05)。결론 자체미립피여이체탈세포미립진피이식확장비위4:1시,체도촉진창면유합적최가비례,유리우미혈관장입급MMP-1、2적괄도표체。
Objective To observe the effect of auto-microskin in the mixture with xeno-acellular dermal micromatrix in the decreasing ratio on the wound healing in rats. Methods Male Wistar rats as donors provided xeno-acellular dermal micromatrix. Sixty female SD rats were enrolled in this study and fullthickness skin defects were made, and were divided into three mixed grafting groups (groups A, B, C), autoskin group (group D) and xeno-dermal matrix group (group E). The area expansion rate of auto-microskin was 5:1 in the groups containing it and the rate of xeno-acellular dermal micromatrix was 5:1 in the group E.Gross and histological morphology was observed. The wound shrinkage, wound vascularization, matrix metalloproteinase (MMP)-1 and MMP-2 were detected. Results (1) At post-graft week 2 and 3, the wound healing rate in these mixed grafting groups was higher than in groups D and E significantly, that in groups B and C (28.94±2.97)％, (30.62±1.94)％ ; (81.14±9.30)％, (88.00 ±5.71)％ was also higher than in group A (28. 36 ±2. 11 )％, (79. 81 ±7.07)％, and the desquamation was observed in the mixed grafting group 1; (2) At post-graft week 2 and 3, the quantities of microvessels in the mixed grafting groups were higher than in groups D and E ( P ＜ 0. 05). At post-graft week 2, the significant difference was found between group A (30. 00 ± 1.83 ) and other mixed grafting groups ( 34. 30 ± 1.70), ( 35. 10 ± 1.79 ) in the quantities of microvessels; (3) The expression of MMP-1 was up-regulated after the occurrence of wound and the level was decreased gradually at the post-graft week 2, 3 and 4, but the level of MMP-1 was higher in the mixed grafting groups (especially groups A and B) than in group D. MMP-2 accumulated in the fluid phase of the wound environment and reached maximal levels at the post-graft week 3. The level of MMP-2 in the mixed grafting groups was higher than in group D. Conclusion The optimal ratio of auto-microskin and xenoacellular dermal micromatrix can accelerate the process of wound healing, and it can promote the proliferation of microvessel and the moderate expression of MMP-1, 2 when the ratio is 4: 1.