中华临床医师杂志（电子版）
中華臨床醫師雜誌（電子版）
중화림상의사잡지（전자판）
CHINESE JOURNAL OF CLINICIANS(ELECTRONIC VERSION)
2013年
19期
8768-8773
,共6页
郭建美%孙楠%仲少敏%陶荣%吴艳
郭建美%孫楠%仲少敏%陶榮%吳豔
곽건미%손남%중소민%도영%오염
葡萄球菌,金黄色%皮肤屏障功能%封包%保湿
葡萄毬菌,金黃色%皮膚屏障功能%封包%保濕
포도구균,금황색%피부병장공능%봉포%보습
Staphylococcus aureus%Skin barrier function%Occlusion%Moisturizing
目的：探讨皮肤屏障功能损伤及采用保湿或封包手段恢复屏障功能与金黄色葡萄球菌（简称金葡菌）定植之间的相互影响。方法使用胶带反复黏贴SKH-1无毛小鼠背部皮肤制造皮肤屏障功能急性损伤模型。将36只小鼠分为对照组、破坏屏障组、接种金葡菌组、破坏＋接种金葡菌组、破坏＋封包＋接种金葡菌组（后简称：封包组）以及破坏＋保湿＋接种金葡菌组（后简称：保湿组）6组。后四组在接种金葡菌24 h后收集局部菌进行培养、鉴定和计数。在屏障功能破坏前、破坏后即刻、封包/保湿后、接种金葡菌后4 h、24 h分别检测小鼠屏障功能相关生理指标。结果胶带反复黏贴后即刻，pH值、TEWL和基线相比明显升高（P＜0.05），24 h角质层含水量低于基线，pH值和TEWL仍高于基线水平（P＜0.05）。封包1 h可降低皮肤表面pH值和TEWL（P＜0.05）；保湿4 h可降低pH值（P＜0.05），TEWL有所下降，但和破坏屏障组同一时间相比无统计学差异。接种金葡菌后24 h，接种组仅有少量的金葡菌生长；破坏＋接种组的金葡菌定植量远高于接种组（P＜0.05）；封包组和保湿组金葡菌定植的数量与破坏＋接种组相比明显减少（P＜0.05）。在屏障功能破坏的小鼠皮肤上接种金葡菌会延缓pH值和TEWL的恢复，和破坏屏障组相比有统计学差异（P＜0.05）。封包和保湿可以消除接种金葡菌抑制屏障功能恢复的作用。结论屏障功能破坏会促进金葡菌的定植，封包和保湿可以促进急性屏障功能破坏的恢复并减少金葡菌的定植，金葡菌定植后会延缓皮肤屏障功能的恢复，封包和保湿可以消除接种金葡菌抑制屏障功能恢复的作用。
目的：探討皮膚屏障功能損傷及採用保濕或封包手段恢複屏障功能與金黃色葡萄毬菌（簡稱金葡菌）定植之間的相互影響。方法使用膠帶反複黏貼SKH-1無毛小鼠揹部皮膚製造皮膚屏障功能急性損傷模型。將36隻小鼠分為對照組、破壞屏障組、接種金葡菌組、破壞＋接種金葡菌組、破壞＋封包＋接種金葡菌組（後簡稱：封包組）以及破壞＋保濕＋接種金葡菌組（後簡稱：保濕組）6組。後四組在接種金葡菌24 h後收集跼部菌進行培養、鑒定和計數。在屏障功能破壞前、破壞後即刻、封包/保濕後、接種金葡菌後4 h、24 h分彆檢測小鼠屏障功能相關生理指標。結果膠帶反複黏貼後即刻，pH值、TEWL和基線相比明顯升高（P＜0.05），24 h角質層含水量低于基線，pH值和TEWL仍高于基線水平（P＜0.05）。封包1 h可降低皮膚錶麵pH值和TEWL（P＜0.05）；保濕4 h可降低pH值（P＜0.05），TEWL有所下降，但和破壞屏障組同一時間相比無統計學差異。接種金葡菌後24 h，接種組僅有少量的金葡菌生長；破壞＋接種組的金葡菌定植量遠高于接種組（P＜0.05）；封包組和保濕組金葡菌定植的數量與破壞＋接種組相比明顯減少（P＜0.05）。在屏障功能破壞的小鼠皮膚上接種金葡菌會延緩pH值和TEWL的恢複，和破壞屏障組相比有統計學差異（P＜0.05）。封包和保濕可以消除接種金葡菌抑製屏障功能恢複的作用。結論屏障功能破壞會促進金葡菌的定植，封包和保濕可以促進急性屏障功能破壞的恢複併減少金葡菌的定植，金葡菌定植後會延緩皮膚屏障功能的恢複，封包和保濕可以消除接種金葡菌抑製屏障功能恢複的作用。
목적：탐토피부병장공능손상급채용보습혹봉포수단회복병장공능여금황색포도구균（간칭금포균）정식지간적상호영향。방법사용효대반복점첩SKH-1무모소서배부피부제조피부병장공능급성손상모형。장36지소서분위대조조、파배병장조、접충금포균조、파배＋접충금포균조、파배＋봉포＋접충금포균조（후간칭：봉포조）이급파배＋보습＋접충금포균조（후간칭：보습조）6조。후사조재접충금포균24 h후수집국부균진행배양、감정화계수。재병장공능파배전、파배후즉각、봉포/보습후、접충금포균후4 h、24 h분별검측소서병장공능상관생리지표。결과효대반복점첩후즉각，pH치、TEWL화기선상비명현승고（P＜0.05），24 h각질층함수량저우기선，pH치화TEWL잉고우기선수평（P＜0.05）。봉포1 h가강저피부표면pH치화TEWL（P＜0.05）；보습4 h가강저pH치（P＜0.05），TEWL유소하강，단화파배병장조동일시간상비무통계학차이。접충금포균후24 h，접충조부유소량적금포균생장；파배＋접충조적금포균정식량원고우접충조（P＜0.05）；봉포조화보습조금포균정식적수량여파배＋접충조상비명현감소（P＜0.05）。재병장공능파배적소서피부상접충금포균회연완pH치화TEWL적회복，화파배병장조상비유통계학차이（P＜0.05）。봉포화보습가이소제접충금포균억제병장공능회복적작용。결론병장공능파배회촉진금포균적정식，봉포화보습가이촉진급성병장공능파배적회복병감소금포균적정식，금포균정식후회연완피부병장공능적회복，봉포화보습가이소제접충금포균억제병장공능회복적작용。
Objective To investigate the interaction between damaged skin barrier and colonization of Staphylococcus aureus;and the impact of occlusion and moisturizer, which can recover the barrier function, on S. aureus colonization. Methods Acute skin barrier impaired model was established by tape-stripping on the back of SKH-1 hairless mice. 36 such mice were divided into 6 groups, the control group, barrier impaired group, S. aureus inoculated group, barrier impaired+S. aureus inoculated group, "occlusion group" (referred to barrier impaired+occlusion+S. aureus ) and"moisturizing group"(referred to barrier impaired+moisturizer+S. aureus). Bacteria on the skin were collected 24 hours later for characterization of the S. aureus. The physiological parameters related to skin barrier were measured at different time points:before, immediately after tape-stripping, after occlusion/moisturizing, 4 hours and 24 hours after inoculation of S. aureus. Results Immediately after tape-stripping, the skin pH and TEWL significantly increased (P<0.05). 24 hours later, the water content in the stratum corneum was still lower and the skin pH and TEWL significantly increased(P<0.05).After occlusion for 1 hour, the skin pH and TEWL significantly decreased (P<0.05). While, after applying the moisturizer for 4 hours, the skin pH significantly decreased (P<0.05), the decrease of TEWL was not so obvious. There was a little S. aureus grown in inoculation group, while the number of S. aureus in impaired barrier group increased dramatically (P<0.05);the colonization of S. aureus in both occlusion and moisturizing group was much less compared with the barrier impaired group (P<0.05). The inoculation on the barrier impaired skin would delay the recovery of barrier function, with higher pH and TEWL (P<0.05). The occlusion and moisturizing could eliminate the suppression on barrier recovery caused by S. aureus. Conclusions The damaged skin barrier would promote the colonization of S. aureus, while the occlusion or moisturizing may enhance the recovery of acute barrier function, thereby reducing the colonization.Meanwhile, the colonization of S. aureus would delay the recovery of the damaged skin barrier, which can be eliminated by occlusion and moisturizing.
