靶向血管治疗增生性瘢痕的实验研究

目的 探讨靶向血管治疗烧伤后增生性瘢痕的可行性和方法。方法 通过建立增生性瘢痕的裸鼠移植模型，使用不同剂量血管内皮生长因子(VEGF)的单克隆抗体，进行瘢痕内注射治疗，观察瘢痕Ⅰ型、Ⅲ型胶原和血管的量以及其超微结构的变化。结果 靶向血管治疗3周后，增生性瘢痕的体积明显减小，瘢痕胶原、血管明显减少，瘢痕内大量成纤维细胞坏死、凋亡，代之成熟的纤维细胞，失去了典型增生性瘢痕的特征。结论 血管内皮生长因子可能对增生性瘢痕中的大量血管新生起支持作用，大量血管对增生性瘢痕的胶原合成可能起着促进作用，针对VEGF的靶向血管治疗可能是治疗增生性瘢痕的的一种有意义的方法。

A research of endothelial cell-targeted therapy for cure of hypertrophic scar

OBJECTIVE: To investigate the feasibility of endothelial cell-targeted therapy to cure post-burn hypertrophic scar. METHODS: A hypertrophic scar animal model was made. Intralesional injecting of VEGF monoclonal antibody was performed for three weeks. The changes of scar in volume and morphology were observed. RESULTS: 1. The volume of scar decreased. 2. The number of the capillary, the amount of collagen I and collagen III decreased. 3. Transmission electron microscope examinations demonstrated many dead or apoptotic fibroblasts and endothelial cells. Fibrocytes were seen relatively common. CONCLUSION: VEGF induces the growth and development of hypertrophic scar in that it induces excessive and uncontrollable angiogenesis, which favors excessive collagen synthesis. Endothelial cell-targeted therapy may be a promising method to cure post-burn hypertrophic scar.