外源性透明质酸影响脱细胞真皮基质复合移植组织Ⅰ、Ⅲ型胶原蛋白表达的实验研究

目的 探讨外源性透明质酸(HA)对异种(猪)脱细胞真皮基质(PADM)复合移植后组织中Ⅰ、Ⅲ型胶原蛋白的影响.方法 以30只日本大耳白兔为实验动物,在其背部制作伞层皮肤缺损动物模型,随机分为HA+PADM+薄自体皮移植组(A组)、PADM+薄自体皮移植组(B组)和薄自体皮移植组(C组)3组.术后50 d取材,采用病理学、免疫组化、Western印迹等方法检测Ⅰ、Ⅲ型胶原蛋白的变化并进行统计学对比分析.结果 A、B、C组植皮后面积分别为(13.3 4±1.2)、(9.5.4±0.9)、(10.0±1.4)cm2,A组明显大于B组和C组(P<0.01),B组和C组相比差异无统计学意义(P>0.05).3组Ⅰ型胶原蛋白表达分别为1894±164、515±38、395±43,A组明显高于B、C组(均P<0.01);m型胶原蛋白表达分别为5411±435、874±70、2078±175,A组>C组>B组(均P<0.01);Ⅰ/Ⅲ型胶原比例分别为0.35、0.59、0.19,A、B组均明显高于c组(均P<0.01).结论 外源性HA能够增加复合皮肤移植后Ⅰ、Ⅲ型胶原蛋白表达,降低Ⅰ/Ⅲ型胶原蛋白比例,有利于复合皮移植后真皮和基底膜的重塑,有助于减轻挛缩,改善复合皮移植质量.

Abstract：

Objective To investigate the changes of collagens Ⅰ and Ⅲ after the addition of hyaluronic acid in the transplantation of porcine acellular dermal matrix.Methods Full-thickness skin defects were created on the dorsa of Japanese white rabbits.And the rabbits were divided randomly into 3 groups:Group A(hyaluronic acid,porcine acellular dermal matrix plus thin skin autografts),Group B (porcine acellular dermal matrix plus thin skin autografts)and Group C (skin autografts).Skin biopsies were performed at Day 50 post-grafting to detect the contents of collagens Ⅰ and Ⅲ by histological examinations,immunohistochemistry method and Western blot.Results The areas of skin graft were(13.34±1.2),(9.5±0.9)and(10.0±1.4)cm2 in Groups A,B and C respectively.Group A was larger than Groups B and C(all P<0.01).There was no statistical difference between Groups B and C(P>0.05).The expressions of collagen Ⅰ were 1894±164,515±38 and 395±43 in Groups A,B and C respectively.Group A was higher than Groups B and C(P<0.01).And the expressions of collagen Ⅲ were 5411±435,874±70 and 2078±175 in Groups A,B and C respectively.Group C was higher than Group B and yet lower than Group A(all P<0.01).The ratios of collagen Ⅰ and collagen Ⅲ in Group A(0.39)and Group B(0.59)were higher than that of Group C(O.19)(all P<0.01).Conclusion The addition of hyaluronic acid may boost the expression of collagens Ⅰ andⅢand decrease the ratio of collagen Ⅰ/collagenⅢ.Thus it facilitates wound healing and basilar membrane remodeling and alleviates the contraction of skin transplant.