外源性透明质酸对创面愈合影响的研究

目的　探讨透明质酸 (HA)延迟创面愈合的作用。方法　成年日本大耳白兔 18只 ,建立兔耳创伤愈合模型 ,随机分成 2 % HA治疗组 (A组 ) ,1% HA治疗组 (B组 ) ,磷酸盐缓冲液 (PBS)对照组 (C组 ) ,进行大体形态、组织学变化、平均愈合时间、创面收缩情况、残余创面面积、成纤维细胞 α-平滑肌肌动蛋白表达及超微结构 ,观察 12天。结果　 1三组创面平均愈合时间为 (11.7± 0 .6 )、(11.3± 0 .6 )和 (10 .8± 1.0 )天 ,三组之间有显著差异 (P<0 .0 5 ) ;A、B组与C组比较创面收缩速率及残余面积也有统计学意义 (P<0 .0 5 )。 2组织学见 A、B两组胶原纤维较细 ,排列整齐 ;C组胶原纤维较粗大 ,排列紊乱。 3A、B组 α-平滑肌肌动蛋白的表达少于 C组 ,有统计学意义 (P<0 .0 1)。结论　 HA通过抑制成纤维细胞向肌成纤维细胞转化而抑制创面收缩 ,是延迟创面愈合的原因之一 ;且这一作用与其浓度有依赖关系。

EFFECT OF EXOGENOUS HYALURONAN ON WOUND HEALING

OBJECTIVE: To investigate the mechanism of impeded wound healing by exogenous hyaluronan (HA). METHODS: Wound healing models were established on 18 adult rabbit ears, which were randomly divided into 3 groups, the 2% HA treated-group (group A), the 1% HA treated-group(group B), and the PBS control group (group C). The process of wound healing was observed morphologically and histologically. The expression of alpha-smooth muscle actin in fibroblast was measured by immunohistochemical method. RESULTS: 1. The mean values of wound healing time of groups A, B and C were (11.7 +/- 0.6), (11.3 +/- 0.6), and (10.8 +/- 1.0) days respectively. Wound contraction was greater in group C than in group A and group B. 2. Compared with PBS controls, the collagen fibril was slender and arrayed regularly in HA treated wound. 3. The expression of alpha-smooth muscle actin was greater in group C than in groups A and B. CONCLUSION: It is one of reasons of impeded wound healing that exogenous HA inhibits the expression of alpha-smooth muscle protein and wound contraction. There exists dose-dependent effect.