增生期和成熟期皮肤瘢痕中的神经纤维形态学观察精.docVIP

???? 增生期和成熟期皮肤瘢痕中的神经纤维形态学观察 　　作者：李霞 作者单位：山东大学附属省立医院烧伤整形科， 济南 250021 　　【摘要】 目的 观察不同时期增生性瘢痕(HS)中神经纤维数量和形态的变化。方法 标本取自烧伤或创伤后HS形成1月～23年的患者，分为增生期瘢痕组(≤6月)和成熟期瘢痕组(6月)，正常对照组取自患者的供皮区。利用单克隆抗神经丝蛋白(NF)抗体免疫荧光染色技术，在荧光显微镜和激光扫描共聚焦显微镜(LSCM)下观察不同时期瘢痕组织和正常皮肤组织中神经纤维的差异。结果 增生期瘢痕组神经纤维的阳性面积比明显高于正常对照组(P0.05)，神经纤维分布杂乱，形态不规整，有局部的扭曲变细和肿胀断裂;成熟期瘢痕组神经纤维的阳性面积比明显低于正常对照组(P0.05)，神经纤维排列较规整，内部结构和立体结构均接近正常。结论 瘢痕增生过程中神经纤维的密度和形态皆随时间变化而变化。 　　【关键词】 瘢痕 肥大性 神经微丝蛋白质类 神经支配 神经再生 　　(1. Department of Plastic Surgery, Provincial Hospital Affiliated to Shandong University, Jinan 250021, China; 　　2. Shandong Medical College, Jinan 250002, China) 　　To observe the changes of number and morphology of nerve fibers in different periods of hypertrophic scar(HS). Methods Samples were obtained from postburn or posttraumatic(1 months23 years) patients and divided into two groups: the proliferative HS group (six months). The control samples were taken from donor sites of patients. Immunofluorescent staining technique with antineurofilament(NF) monoclonal antibody was employed to determine the expression of NF in scars and normal skin. The morphology of nerve fibers in hypertrophic scars and normal skin was investigated with a light microscope and a laser scanning confocal microscope (LSCM). Results The positive area ratio of nerve fibers was much higher in the proliferative HS group than in the control group(P0.05), and the nerve fiber was in an irregular shape and had a disordered distribution with local swelling, twisting and disconnection. However, the positive area ratio of nerve fibers was much lower in the mature HS group than in the control group(P0.05), and the nerve fiber was orderly arranged with the continuance of inner structure and stereoscopic structure similar to normal skin. Conclusion Innervation in HS gradually changes with scarring maturation, and nerve fibers may play roles in scar formation related to the morphologic changes. 　　Key words: Cicatrix, hypertrophic;　Neurofilament proteins;　Innervation;　Ner