摘要
在异体皮、自体皮片混合移植的大鼠Ⅲ度烧伤模型上观察了移植后4、7、14、21、28d时羟脯氨酸、Ⅰ型和Ⅲ型胶原、前Ⅲ型胶原N端多肽（PⅢNP）和胶原酶活性的变化规律。应用特异性强、灵敏度高的单克隆抗体检测Ⅲ型胶原和PⅢNP。结果发现：自体皮区移植14d后羟脯氨酸、Ⅲ型胶原和胶原酶活性显著增加，Ⅲ／Ⅰ比例非常明显增高。在异体皮区移植后14d内，羟脯氨酸、Ⅰ型和Ⅲ型胶原活性降低，至21d后才见羟脯氨酸和Ⅲ型胶原，Ⅲ／Ⅰ增加；相反地。Ⅰ型胶原在移植后4、7、14d均见降低。实验证实了血清中PⅢNP能灵敏地反应局部烧伤后Ⅲ型胶原合成的增加，移植后7～28d均见PⅢNP显著升高。局部组织学观察在混合移植后21d异体表皮完全被排异，异体真皮已完全被延伸的自体表皮所覆盖。结果表明：异体皮区胶原代谢的启动迟于自体皮区约1周左右。混合移植14d自体皮区胶原合成开始活跃，而新生合成的胶原主要是Ⅲ型胶原，28d后创面已完全被自体表皮覆盖，其下的胶原代谢仍未停止，无论在原先的自体皮区及异体皮区胶原的合成，代谢仍在高水平进行。混合移植不仅防止了感染、高能代谢、水和电解质紊乱和对付自体皮不足，而且对烧伤愈合中的胶原代谢有显著作用。
In third degree burn rats after escharectomy and intermingled skin transplantation(a large sheet of allograft inlaid with small stamps of autoskin), we observed wound collagen metabolism of hydroxyproline, type Ⅰ and Ⅲ collagen, serum PⅢNP and collagenase on 4th, 7th, 14th, 21st and 28th postoperative days. The PⅢNP and typeⅢ collagen were determined by monoclone antibody with high specificity and sensitivity. We found significant difference of collagen metabolism between autograft and allograft areas.In autograft areas, hydroxyproline, typeⅢ collagen and collagenase increased significantly after 14 days post transplantation. A significant increase of Ⅲ/ Ⅰ collagen ratio accompanied with it. In allograft areas, the hydroxyproline, type Ⅰ and Ⅲ collagen and collagenase decreased at 14th post-operative day. An increase of hydroxyproline and type Ⅲ collagen was seen after 21 days.During biosynthesis of typeⅢ collagen, PⅢNP cleaves from procollagen to access the synthesis of collagenⅢ in local burn wound. This study proves that sertun PⅢNP can reflect sensitively the local synthesis of typeⅢ collagen in burns. Serum PⅢNP was higher after 7th postoperative day.These results suggest that in intermingled skin transplantation the collagen metabolism of allograft started about one week later than autograft area. The local synthesis of collagen in autograft area became active at the beginning of 14th postoperative day. The new synthesized collagen was type Ⅲ collagen. Although at 28th day after the intermingled skin transplantation the wound was completely covered by autoepidermis, the collagen in the dermal layer was still synthesized at high level. Whether autograft area or allograft site, the metabolism and reconstruction of collagen continued steadily. Therefore the use of the intermingled skin transplantation in large third degree burns not only covers the burn wound to prevent from infection, hypermetabolism, water and electrolyte disturbances and to counteract the insufficiency of autoskin but also contributes the significant effects to collagen metabolism favorable to wound healing. Hereafter it is necessary to further investigation about the final fate of allodermis collagen,the transformation and domination of newly formed collagen after intermingled skin transplantation.
出处
《上海交通大学学报（医学版）》
CAS
CSCD
1997年第S1期46-51,共6页
Journal of Shanghai Jiao tong University:Medical Science
基金
国家自然科学基金!39290700-6
