强脉冲光治疗兔耳增生性瘢痕

目的探讨强脉冲光（intense pulsed light，IPL）对兔耳增生性瘢痕的作用及机制。方法选取新西兰大白兔30只，在每只兔耳腹侧面制作2个增生性瘢痕模型，随机分为治疗组和对照组。治疗组瘢痕在建立模型第3、5、7周采用IPL进行治疗，对照组不进行治疗。观察各组瘢痕形态变化，并且于建立模型第3、5、7周IPL治疗前及建立模型第9周采集各组瘢痕组织标本，苏木精-伊红（HE）染色，采用免疫组织化学方法检测“平滑肌肌动蛋白（a—smooth mascle actin，a—SMA）、血管内皮细胞生长因子（vascular endothelial growth factor，VEGF）、增殖细胞核抗原（proliferating cell nuclear antigen，PCNA）的表达，并利用a—SMA的表达进行微血管密度（microvessel density，MVD）计数，观察微血管变化。建立模型9周时，切取正常喂养的2只兔子的腹侧正常皮肤组织标本进行同上的检查。结果经IPL治疗后的同期瘢痕色泽变淡、厚度降低。IPL治疗组瘢痕软化、完全平坦所需时间较对照组缩短。组织内a-SMA、VEGF和PCNA的表达均降低，差异有统计学意义（P〈0．05）。结论IPL对兔耳增生性瘢痕有明显的治疗作用。

Effect of intense pulsed light in hypertrophic scars in rabbit ear

Objective To explore the effect and mechanisms of intense pulsed light (IPL) in treating hypertrophic scars on rabbit ear.Methods Thirty New Zealand white rabbits were incruited in this study.Two hypertrophic scar models were made in the ventral surface of the rabbit ears with two lesions on each ear.The rabbits were divided randomly into two groups:the treatment group and the control group.Rabbits in the treatment groups were treated by IPL at the 3rd,5th,7th week after operation.Rabbits in the control groups were untreated.Morphological appearances of the hypertrophic scar were observed,and biopsies of scar were taken for HE stain and immunohistochemistry for the expression of vascular endothelial growth factor (VEGF),proliferating cell nuclear antigen (PCNA) and α-SMA,microvessel density was calculated by the expression of α-SMA at the 3rd,5th,7th,9th week after operation.At the 9th week after the operation,the ventral surface skin from two normally-fed rabbits were collected to undergo the same examination above.Results Comparing with the control group,the height of scars was reduced significantly in the IPL treatment group.The scars becaming soften and completely flat needed less time in the IPL treatment group.Comparing with the control group,the level of α-SMA,MVD,VEGF and PCNA expression in the treatment group obviously decreased over the same period (P＜0.05).Conclusions IPL is of great therapeutic effect on treating hypertrophic scar of rabbit ear.