大鼠皮肤创伤愈合瘢痕三维重建及体积定量.docVIP

大鼠皮肤创伤愈合瘢痕三维重建及体积定量 　作者：李幼忱，李志，刘杰，王德文，姜志国，马俊杰，高亚兵，左红艳，康悦 【摘要】 目的 对大鼠皮肤创伤愈合形成的瘢痕进行三维重建和体积定量，探索其在创伤愈合实验研究瘢痕评价中的应用。方法 Wistar大鼠8只，麻醉下制背部直径8 mm的圆形全层皮肤缺损。术后1个月取愈合区皮肤常规固定，制备等距连续石蜡切片（切片间距为200 μm），HE染色。光镜下采集组织学照片，依据瘢痕的形态学特征圈定瘢痕图像。利用ImagingSur3D专用计算机软件对瘢痕进行三维重建和体积计算。 结果 每份标本获得含瘢痕组织的等距连续切片15～20张，经三维重建得到愈合组织中瘢痕的立体形态，似呈残存树桩样，中央较大，周边呈不规则根状伸入正常真皮。瘢痕平均体积为4.292±1.009 mm3。结论 三维重建技术重现了皮肤创伤愈合中瘢痕的真实形态，获得的体积参数可作为创伤愈合实验研究中瘢痕评价的定量指标。 【关键词】 创伤愈合； 瘢痕评价； 三维重建； 体积定量 Abstract: Objective The purpose of this study was to investigate the feasibility of threedimensional (3D) reconstruction and volume quantitative estimation of scar formed in experimental studies of skin wound healing. Methods A fullthickness skin defect wound (8 mm in diameter) was cut in the back of Wistar rats (n=8). 1 month after operation, samples including scar were harvested, fixed and embedded. Histological serial paraffin sections (200 μm apart) were obtained and stained with HE, which were digitally imaged using a microscope and digital camera linked to a personal computer. The scar image was prepared upon its pathological character. ImagingSur3D software was used for 3D reconstruction and volume estimation. Results Fifteen to twenty sequential sections including scar from each sample were used for 3D reconstruction and volume estimation. The spatial arrangement of the scar looked like a stump of a tree with roots extenting into surrounding normal dermis. The average volume of a scar was about 4.292± 1.009 mm3. Conclusion This study demonstrates the 3D shapes of the scar in the skin and provides quantitative volume data of scar, making a better scar assessment scale in experimental studies of skin wound healing. Key words: wound healing; scar assessment; threedimensional reconstruction; volume quantitation 成体皮肤全层损伤最终以瘢痕愈合，不但带来美容问题，严重者可引起局部功能障碍。因此，如何减少皮肤创伤愈合中的瘢痕形成和对已有瘢痕的治疗研究是创伤愈合研究的重要组成部分，其方法和手段涉及物理（激光、放射）、化学（药物）和生物技术（生长因子、干细胞）等多项领域。如何准确地评价各种治疗方法的有效性，其中对瘢痕的定量评价至关重要［1］。 目前使用较多、较为成熟的瘢痕评价方法是通过对瘢痕的色泽、厚度和韧性进行半定量评分或