反复快速皮肤扩张对皮瓣PCNA表达的影响

目的通过动物实验研究反复快速扩张方式的扩张机制。方法 62只雄性新西兰大白兔随机分为A、B、C、D、E 5组。各组取扩张皮肤标本进行HE染色及PCNA免疫组织化学染色,并进行对比观察。结果①组织学观察:A、C组在不同维持期组织学表现接近,B组在维持期1～3周均有大量胶原纤维断裂,D、E组无区别;②PCNA结果:A、B、C 3组中PCNA表达阳性细胞较多,D组较少,正常皮肤中的则更为稀少且散在;③成纤维细胞PCNA阳性结果:A组中除维持期3周时与B组无显著性差异外,余下各组均有显著性差异,其增殖趋势与常规扩张时成纤维细胞的增殖趋势接近,增殖率与常规扩张方式有显著性差异;④表皮细胞PCNA染色阳性率比较:维持1周A组与B、C组间无显著性差异,A、B组与其他2组间有显著性差异,C组与D组有显著性差异,在维持2,3周反复快速扩张与单纯扩张无差异,与其他3组有显著性差异,至维持4,6周时A组与其他4组有显著性差异。结论反复快速扩张皮肤可促进扩张皮肤中成纤维细胞及表皮细胞增殖,增强了组织的生物性生长行为,促进扩张皮肤组织的生长,从而有效缩短皮肤扩张修复治疗疗程。

Effect of the repeated rapid skin expansion on the expression of PCNA in flap

Objective It is to provide a theoretical basis for the clinical application of the rapid expansion by animal experiments.Methods 62 male rabbits were randomly divided into group A,B,C,D and E.The sections were made and stained with HE and immunohistochemistry,and were observed and compared.Results ① Histological observation: the histological characteristics in group A were similar to group C at the different periods of maintain phases.In Group B,there was a great deal of collagen fiber splitting,the change of the epidermis layer was not obviously,and the nuclei of epidermal cells were smaller relatively and the arrangement of epidermal cells was not regular.②PCNA results: in group A,B and C there were more positive cell,fewer in group D,and scarce,scatted in the normal skin.③The comparison of the fibroblasts PCNA-positive rate: there were significant difference between group A and the others in all the periods,except no significant difference with group B at the 3 weeks;the fibroblast proliferation in the repeated rapid expansion group had the similar trends with that of the conventional expanded group.④PCNA epidermal cells staining positive rate: in the first week there was no difference among group A,B and C,but with difference between group A,B and the other two groups,with difference between group C and D.At the 2 and 3 weeks,there was no difference between the repeatedly rapid expansion and the rapid expansion groups,with difference in the other 3 groups;at the 4 and 6 weeks,the were differences between group A and the others.Conclusion The repeatedly rapid skin expansion can promote the proliferation of fibroblasts and epidermal cells in the expanded skin,and can shorten the period of treatment effectively.