微等离子体射频对兔耳增生性瘢痕的疗效及对其MCP-1含量影响

发布时间：2018-07-06 09:00

本文选题：微等离子体射频技术 + 增生性瘢痕　；参考：《河北医科大学》2017年硕士论文

【摘要】：目的:微等离子体射频(Micro-Plasma Radiofrequency,简称MPR)现已广泛应用于面部除皱、换肤、浅表瘢痕的治疗等多种临床疾病,但对于增生性瘢痕(Hypertrophic Scar,简称HS)的作用机制研究较少,本实验通过对比研究的方法来探索兔耳HS应用MPR治疗后其大体形态的变化和其中单核细胞趋化蛋白-1(monocyte chemotactic protein-1,简称MCP-1)的表达变化,为MPR治疗早期HS提供实验依据。方法:将6只新西兰大耳白兔在实验室分笼适应性饲养48小时后,参照李荟元等兔耳增生性瘢痕模型的制作方法,在全麻下于每只兔耳中段腹侧面,沿长轴,使用8mm直径规格圆形环钻做6个圆形深达软骨膜的创面,圆形创面间隔1.5cm,6只新西兰大白兔共形成72个创面。造模术后3天左右创面结痂,7天左右完成上皮化,28天创面组织进入瘢痕增生高峰期,并持续1周左右;此时所形成创面表面痂皮脱落,大部分瘢痕高于皮肤表面,呈红色、质地较硬。造模术后28天,观察到6只兔子共形成72处瘢痕,然后将每只兔子的双耳随机平均分配到实验组和对照组。于兔耳增生性瘢痕造模术后第30天,对实验组36处增生性瘢痕进行微等离子体射频治疗。治疗参数为滚轮治疗头,0.6ms,80w。滚轮头治疗时轻按治疗头并保持治疗头与皮肤垂直,在治疗区内匀速滚动(约6cm/s),共治疗1次。治疗后实验组增生性瘢痕表面外用红霉素软膏,每日1次,用药1周。对照组所有36处增生性瘢痕表面外用红霉素软膏,每日1次,用药1周;不进行微等离子体射频治疗。造模60天后切取实验组和对照组HS组织制作标本,切片后进行组织学研究,并采用免疫组化检测瘢痕内MCP-1含量。此后应用ImagePro Plus 6.0(Media Cybernetics)图像处理软件统计出每视野的MCP-1染色阳性细胞的所占的面积及其积分平均光密度值,并将此平均光密度值采用SPSS软件进行t检验。结果:1肉眼观结果治疗组HS采用MPR治疗后平均2.4±1.5天痂皮脱落。痂皮脱落后,治疗区域均未见创面存在。MPR治疗区域的HS与对照组相比,颜色变浅,呈淡红色,质地变软,瘢痕的高度变低。2组织学结果对照组真皮层较薄,成纤维细胞增生,胶原纤维增生且排列紊乱。实验组未见坏死组织在表皮浅层残留,成纤维细胞增生不明显,胶原纤维增生少于对照组,且排列相对整齐。3 MCP-1免疫组化结果及统计分析两组MCP-1染色阳性细胞的平均光密度值经比较t检验,t值为6.48,P=0.00,按照P0.05的标准,有统计学意义。结论:1 MPR对早期兔耳增生性瘢痕治疗有效。2 MPR抑制了MCP-1的合成,从而降低了成纤维细胞异常增殖、抑制了瘢痕增生。
[Abstract]:Objective: Micro-Plasma Radio Frequency (MPR) has been widely used in the treatment of facial wrinkle, skin replacement, superficial scar and other clinical diseases, but the mechanism of hypertrophic scar (HS) is less studied. The purpose of this study was to explore the changes of gross morphology and the expression of monocyte chemoattractant protein 1 (monocyte chemotactic protein-1 (MCP-1) in rabbit ears after MPR therapy, and to provide experimental evidence for the early treatment of HS. Methods: six New Zealand big ear white rabbits were fed in a laboratory cage for 48 hours. According to the method of making hypertrophic scar model of rabbit ear such as Li Yuanyuan, under general anesthesia, 6 rabbits were placed on the ventral side of each rabbit ear, along the long axis. A total of 72 wounds were formed in 6 New Zealand white rabbits with a circular wound interval of 1.5 cm ~ (-1) by using 8mm diameter specification circular annular drill to form 6 round deep chondrocytes. The wound tissue reached the peak of scar proliferation in 28 days after modeling 3 days after operation, and lasted for about 1 week, most of the scar was higher than the skin surface, and the wound tissue was red, and the wound tissue had reached the peak of scar proliferation in 28 days after model making, and most of the scar was higher than the skin surface, and the scar was red. The texture is hard. On the 28th day after modeling, 72 scars were observed in 6 rabbits, and each rabbit's ears were assigned to the experimental group and the control group at random. 36 hypertrophic scars in experimental group were treated with microplasma radiofrequency on the 30th day after modeling hypertrophic scar in rabbit ear. The parameters of the treatment were as follows: 0. 6 Ms for 80 ws. Press the healing head and keep the head perpendicular to the skin when the roller head is treated, and roll uniformly in the treatment area (about 6cm/s) for a total of 1 time. The experimental group was treated with erythromycin ointment once a day for 1 week. All 36 hypertrophic scars in the control group were treated with erythromycin ointment once a day for 1 week. After 60 days of model making, the HS tissues of the experimental group and the control group were cut to make the specimens, and the histological study was carried out, and the MCP-1 content in the scar was detected by immunohistochemistry. After that, the area of MCP-1 staining positive cells and their integral mean optical density were calculated by Image Pro Plus 6.0 (Media Cybernetics) image processing software, and the mean optical density was tested by SPSS software. Results the mean eschar of HS group was 2.4 卤1.5 days after MPR treatment. After exfoliation of callus, there was no HS in the treatment area. Compared with the control group, HS of the treatment area was lighter, softer, and the height of scar was lower. 2 the histopathological results showed that the dermis of the control group was thinner and fibroblasts proliferated. Collagen fibers proliferate and are disordered. In the experimental group, no necrotic tissue remained in the superficial epidermis, fibroblast proliferation was not obvious, and collagen proliferation was less than that in the control group. The average optical density of MCP-1 staining positive cells in the two groups was 6.48 P0. 00by t test, which was statistically significant according to the standard of P0.05. Conclusion in the treatment of early hypertrophic scar of rabbit ear, 1: 1 MPR can effectively inhibit the synthesis of MCP-1, thus decrease the abnormal proliferation of fibroblasts and inhibit the proliferation of scar.
【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R622

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