摘要
目的 观察人瘢痕组织脱细胞真皮基质（ADM）的组织结构和生物力学性能.方法 取8例人成熟瘢痕、8例人增生性瘢痕和4例人正常皮肤,分别将其真皮层用鼓式取皮刀制备成约0.5 mm厚皮片,用2.5 g/L胰蛋白酶及体积分数0.5％ Triton X-100脱细胞处理制造出ADM;然后通过大体、组织学HE染色、扫描电镜观察其组织结构的差别,并分别进行离体接种人表皮干细胞培养,观察其细胞黏附生长情况的不同;最后通过检测每种ADM的应力-应变关系、应力松弛、蠕变和最大拉伸应力,分析其生物力学性能的差异.结果 制备的ADM均呈瓷白色,正常皮肤和成熟瘢痕的ADM质地柔软、有弹性,而增生性瘢痕的ADM质地稍差;光学显微镜和扫描电镜下可见各种ADM均无细胞存在,正常皮肤ADM胶原纤维均匀、排列规则有序,成熟瘢痕ADM胶原纤维粗细不等、排列稍紊乱,增生性瘢痕ADM胶原纤维排列较为致密紊乱;离体接种人表皮干细胞2周后三种ADM上均有表皮干细胞黏附生长,在正常皮肤和成熟瘢痕ADM组织表面和内部呈聚集生长,在增生性瘢痕ADM组织表面呈黏附生长;增生性瘢痕、成熟瘢痕、正常皮肤三种ADM的应力-应变参数β值（3.024±0.413、2.595±0.443、2.590±0.366）、蠕变斜率（0.018±0.003、0.019 ±0.009、0.023 ±0.010）和最大拉伸应力（8.971 ±2.434、11.011±1.492、15.567±2.931）差异均无统计学意义（均P＞0.05）;成熟瘢痕与正常皮肤ADM的应力-应变伸长比（0.238±0.083与0.291±0.048）、松弛斜率（-0.041±0.009与-0.047±0.008）、松弛量（0.775±0.194与0.968±0.211）、蠕变量（0.033±0.022与0.049±0.020）差异均无统计学意义（均P＞0.05）,而增生性瘢痕ADM的上述指标（0.188 ±0.036、-0.033 ±0.006、0.481 ±0.058、0.020±0.005）均显著低于正常皮肤ADM（均P＜0.05）.结论 成熟瘢痕ADM的组织结构、生物力学性能与正常皮肤ADM近似,其生物力学性能优于增生性瘢痕ADM.
Objective To explore the structural and biomechanical properties of acellular dermal matrix （ADM） of human scar tissue.Methods Randomly choose 8 human mature scar tissue,8 human hypertrophic scar tissue,and 4 normal human tissue as.experimental samples respectively.Then 0.5 mm split-thickness skin grafts were obtained by drum-type scalpel,further acellularized by 2.5 g/L trypsin-0.5％ TritonX-l00.Structural analyses were performed by macroscopic observation,hematoxylin and eosin histological staining and scanning electron microscope.Then human epithelial stern cells were inoculated,cultured on those materials and observe their adhesive properties.Finally the biomechanical properties of ADM were analyzed through the detection of stress-strain relation,stress relaxation,creep and ultimate stress strength to distinguish different origins.Results Prepared ADM was milky white in color despite their distinct origins,physiological and mature scar tissue derived ADM was soft and flexible in texture while ADM from hypertrophic scar showed a more tenacious character.Optical microscopic and electron microscopic analyses showed no sign of visible cellular structures.ADM from physiological group had relatively homogeneous and inerratic collagenous fibers,ADM from hypertrophic group presented with fibers of various diameters and arrayed in a compact and disordered manner.ADM from mature scar tissue possessed traits between the other two groups.Adhesion growth could be observed 2 weeks after inoculating human epithelial stem cells on ADM and cells grew in a cohesive fashion on ADM both from normal skin and mature scar tissue and in an adhesive fashion on hypertrophic scar tissue ADM.Stress-strain 3 value （3.024 ±0.413,2.595 ±0.443,2.590 ± 0.366）,creep slope （0.018 ± 0.003,0.019 ± 0.009,0.023 ± 0.010） and ultimate stress strength （8.971 ± 2.434,11.011 ± 1.492,15.567 ± 2.931） of ADM showed no significant differences in hypertrophic scar,mature scar and normal skin tissues （all P ＞ 0.05）.ADM from mature scar and normal skin tissue showed no differences in stress-strain stretch ratio （0.238 ± 0.083 vs 0.291 ± 0.048）,relaxation slope （-0.041 ± 0.009 vs-0.047 ± 0.008）,total relaxation （0.775 ± 0.194 vs 0.968 ±0.211） or total creep （0.033 ±0.022 vs 0.049 ± 0.020） （all P ＞ 0.05）.However,the above related indices of ADM from hypertrophic scar tissue （0.188 ± 0.036,-0.033 ± 0.006,0.481 ± 0.058,0.020 ± 0.005） were significantly lower than those from normal tissue （all P ＜ 0.05）.Conclusions No significant differences exist between mature scar and normal skin tissues derived ADM both in structural and biomechanical properties.However ADM from mature scar appears to be superior in biomechanical properties than hypertrophic scar derived ADM so that it may become a replacement for original dermis in wound repair.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2015年第10期770-775,共6页
National Medical Journal of China
基金
国家自然科学基金（81201467）
作者简介
现在青海大学附属医院烧伤整形外科
通信作者：宗宪磊，Email：zongxianlei@163．com
