长脉冲1064 nm Nd:YAG激光治疗兔耳增生性瘢痕的实验研究

摘要/Abstract

摘要：

目的通过建立兔耳增生性瘢痕模型，评价长脉冲1064 nm激光治疗增生性瘢痕的疗效。方法选用新西兰长耳白兔10只，雌雄各半，体质量2.0 ~ 2.5 kg。在所有兔耳腹侧面建立增生性瘢痕模型，每只兔耳4处1.5 cm × 1.5 cm正方形造模。10只兔子共80个创面形成增生性瘢痕74处，将左侧和右侧兔耳增生性瘢痕块分为对照组和治疗组，治疗组应用长脉冲1064 nm激光照射，对照组未予治疗。30 d后观察实验组及对照组瘢痕的颜色、质地；彩色超声测量瘢痕厚度；瘢痕取材，HE染色和CD31免疫组化染色，记数瘢痕成纤维细胞密度和微血管密度；Masson染色观察胶原纤维。结果激光治疗组较对照组瘢痕颜色变浅，质地变柔软，瘢痕厚度变薄，对照组瘢痕的平均厚度为3.089 mm，治疗组为2.137 mm，两组比较，t = 5.72，P < 0.01。对照组血管密度均值为68.056个/mm2，治疗组为38.333个/mm2，两组比较，t = 4.93，P < 0.01，治疗组血管密度较对照组明显降低。成纤维细胞数量均值对照组为355.000个/mm2，治疗组为166.940个/mm2，两组比较，t = 13.36，P < 0.01，治疗组成纤维细胞数量明显减少。Masson染色观察对照组胶原纤维排列紊乱，治疗组胶原纤维排列疏松，规则。结论长脉冲1064 nm激光可以促进早期增生性瘢痕消退，对瘢痕增生具有抑制作用。

关键词: 胶原

Abstract:

Objective To evaluate the therapeutic effect of long-pulsed Nd:YAG 1064 laser on hyperplastic scars by using a rabbit ear model. Methods Five female and five male New Zealand long-ear white rabbits weighting 2.0 - 2.5 kg were used in this experiment. Four square full-thickness skin wounds sized 1.5 cm × 1.5 cm were created on the ventral surface of each ear to develop a model of hyperplastic scar. Finally, a total of 74 hyperplastic scars developed on the 80 wounds, and the scars on the left and right ears served as the control （unirradiated） and treatment （irradiated with long-pulsed 1064 nm Nd:YAG laser） group, respectively. After 30 days of irradiation, the color and texture of scars were observed and the scar thickness was measured by color Doppler ultrasonography. Then, the scars were harvested followed by the analysis of density of fibro-blasts and microvessels as well as the changes in collagen fibers in scars by HE staining, CD31 staining and Masson staining, respectively. Results A decrease was observed in the color, hardness and thickness of scars in the irradiated ears compared with the unirradiated ears. The average thickness of scars, microvessel density and fibroblast density in scars were significantly lower in the treatment group than in the control group （2.137 vs. 3.089 mm, t = 5.72, P < 0.01; 38.333/mm2 vs. 68.056/mm2, t = 4.93, P < 0.01; 166.940/mm2 vs. 355.000/mm2, t = 13.36, P < 0.01）. Masson staining revealed a disorganized arrangement of collagen fibers in the control group but a sparse and regular alignment in the treatment group. Conclusion Long-pulsed 1064 nm Nd:YAG laser may promote the shrinkage and suppress the hyperplasia of scars．

Key words: Collagen

尹冬云曹莫刘柳. 长脉冲1064 nm Nd:YAG激光治疗兔耳增生性瘢痕的实验研究[J]. 中华皮肤科杂志, 2011, 44(7): 479-482.

参考文献

1. Woo WK,Jasim ZF,Handley JM.532nm Nd:YAG and 595nm pulsed dye laser treatment of leg telangiectasia using ultralong pulse duration [J].Dermatologic Surgery,2003,29:1176-1180. 2. 周国瑜，沈玲悦，田克斌，等.长脉冲可调脉宽Gentle YAG 1064nm激光治疗颌面部血管瘤113例效果评估[J].上海口腔医学,2006,15(3):250-253. 3. 付俊,孙林潮,马睿.长脉冲1064nm Gentle YAG激光治疗皮肤血管瘤259例临床分析.中国国美美容容医医学学2009,18(6),840-842. 4. Civas E,Koc E,Aksoy B.Clinical experiences in the treatment of different vascular lesions using a neodymium-doped yttrium garnet laser.Dermatol Surg,2009:35(12):1933-41. 5. 钱华，徐荣华，吴亚芬等.长脉宽1064nmNd:YAG激光治疗儿童皮肤血管瘤的疗效。中华医学美学美容杂志2009,15(6):361-364. 6. 李荟元刘建波夏炜．增生性瘢痕动物实验模型的建立与应用．中华整形外科杂志，2001．17(5)：276-278． 7. 牛扶幼，牛永敢，陈言汤．兔耳增生性瘢痕模型的建立[j]．中国医学工程，2004，12(5)：12-14． 8. 林晓曦，王炜，曹谊林.血管瘤和血管畸形治疗中的美容原则探讨.中华医学美学美容杂志,2003,6(9):190-192. 9. W eidner N． Current pathologic methods for measuring intmtumoral microvessel density within breast carcinoma and other solid tumors．Breast Cancer Res Treat，1995，36：169—180. 10. Kischer CW, Shetlar MR, Chvapil M. Hypertrophic scars and keloids: a review and new concept concerning their origin. Scan Electron Microsc 1982，4:1699–1713. 11. AmadeuT, Braune A, Mandarim-de-Lacerda C,et al. Vascularization pattern in hypertrophic scars and keloids: a stereological analysis. Pathol Res Pract, 2003, 199:469-473. 12. Wang Xi-Qiao, Liu Ying-Kai,Qing Chun,Hyperactivity of fibroblasts and functional regression of endothelial cells contribute to microvessel occlusion in hypertrophic scarring 2009,77（2），204-11. 13. 张琳西郭树忠夏文森杨力王臻血管内皮细胞对增生性瘢痕成纤维细胞增殖的影响中华整形外科杂志，2002年18（6）：330-334. 14. Lee, C.N., Cheng,W.F., Chang, M.C., Su, Y.N., Chen, C.A., Hsieh, F.J., 2005. Hypoxia-induced poptosis in endothelial cells and embryonic stem cells. Apoptosis 10, 887–894. 15. Eguchi, R., Suzuki, A., Miyakaze, S., Kaji, K., Ohta, T., 2007. Hypoxia induces apoptosis of HUVECs in an in vitro capillary model by activating proapoptotic signal p38 through suppression of ERK1/2. Cell Signal. 19, 1121–1131. 16. Yanyan, C,Guoxian, Q,Yang, G.,Leting,W., 2008. Mechanism of hypoxia-induced factor1alpha expression in endothelial cells of the human umbilical vein and its induction of apoptosis. Mol. Biol. Rep. 35 (3), 285–290. 17. 孙晓燕，王星武，郭党学等，ALA光动力治疗兔耳增生性瘢痕模型的实验研究.中国美容医学杂志，2009，18（7）：974-976. 18. 李虎李小静宁金龙孟刚高凤山董继英血管生长抑制因子对兔耳增生性瘢痕的作用及意义.中华医学美学美容杂志，2007，13（4）237-239. 19. 宋保强，鲁开化，郭树忠等重组血管生成抑制剂Ad—METH一1对兔耳增生性瘢痕的抑制，中国实用美容整形外科杂志.2005,16（6）377-380. ), 285–290. ), 285–290.

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