摘要
目的探索自体全层皮肤移植成活过程中表皮干细胞随微环境的改变而变化的规律,为表皮干细胞的临床应用提供理论依据。方法Wistar大鼠42只,于背部制作1.5cm×1.5cm自体全层皮肤原位移植模型。按取材时间点随机分成7组(G1～G7组),每组6只,分别为术后第1、3、5、7、14、21和30天;各组术前取材作对照。在各时间点大体观察移植皮片情况;于手术前、后各时间点切取皮片组织标本,行HE染色和免疫组织化学染色,观察组织学变化及整合素β1和基因物质p63阳性细胞变化。结果术后第3天,G5、G6组各有1只动物移植皮片周围感染,其他各组移植皮片均成活良好。G1～G4组细胞水肿,炎性细胞浸润,纤维细胞逐渐增多,G5～G7组上皮化程度越来越高,纤维细胞含量越来越少。各组整合素β1阳性细胞率低于基因物质p63,但随观察时间延长变化规律相似。阳性细胞在移植皮片中的排列结构紊乱,分布到表皮各层,从G6组开始逐渐集中于表皮的基底层和毛囊隆突部,但在表皮的其他各层仍然有阳性细胞。G1组阳性细胞率开始逐渐减少,G2组达到最低,然后逐渐增加,G1～G3组手术前、后比较差异均有统计学意义(P<0.05);G4组接近术前(P>0.05);G6组达到最高峰后逐渐降低,G5～G7组手术前、后比较差异均有统计学意义(P<0.05)。结论表皮干细胞在自体全层皮片移植成活过程中,数量逐渐减少后增加,至超过正常,后又逐渐减少;在分布上开始紊乱,几乎分布表皮各层,后又趋向正常规律性变化。
Objective To provide theoretical evidence for clinical application of the epidermal stem cells after an investigation on changes of the epidermal stem cells during the survival process after the full-thickness skin autograft. Methods On the backs of 42 Wistar rats, orthotopic transplantation models （1.5 cm×1.5 cm） of the fullthickness skin autograft were made. According to the time of the specimen taking, at 1, 3, 5, 7, 14, 21 and 30 days after operation, the rats were randomly divided in 7 groups （Groups 1-7）. Specimens taken in each group before operation were used as controls. At each time point, the gross observation was made on the transplanted skin flaps, from which the skin tissues were harvested at each time point before and after operation. The routine pathological and the immunohistochemical examinations were performed on the specimens, which were stained by HE and were observed for immunohistochemical changes and the changes in the cells positive for integrin β1 and p63. Results All the full- thickness skin autografts survived 3 days after operation except the skin autograft in 1 rat in both Group 5 and Group 6, which was infected around the transplanted skin flap. In Groups 1-4, cell edema, inflammatory cell infiltration, and increased fibrocytes were observed. In Groups 5-7, the maturity degree of the epithelial cells became higher and higher, and the fibrocyte proportion was lowered. In each group the cell positivity rate for integrin β1 was lower than the cell positivity rate for p63. The positive cells were arranged in disorder, distributed into the layers of the epidermis and gradually concentrated in the basal layer of the epidermis and the bulge of the folliculus pili. The positive cells were also found in the other layers of the epidermis. The positive cells were gradually decreased in number, and reached the lowest level in Group 2. There was a significant difference in the above variables in Groups 1,2,3,5,6 and 7 between before and after operations （P〈0.05）. Conclusion Duri
出处
《中国修复重建外科杂志》
CAS
CSCD
北大核心
2007年第12期1376-1380,共5页
Chinese Journal of Reparative and Reconstructive Surgery
基金
衡阳市科技局科技计划资助项目(2005KS01-019)~~
