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目的 探讨瘢痕形成对汗腺再生的影响。 方法 分别取幼儿和成人大面积深度烧伤后瘢痕组织及其自身健康皮肤组织 ,切片后采用免疫组化方法检测角蛋白 19(K19)和角蛋白14(K14)在瘢痕组织中汗腺分泌部和导管部的表达 ,并以此确定汗腺在瘢痕组织中的定位和分布。同时 ,采用HE染色法观察正常皮肤组织中汗腺组织的分布。 结果 正常皮肤中可见完整的汗腺结构 ,包括汗腺分泌部和导管部。瘢痕组织中可见K19和K14的阳性表达信号 ,其中K19的阳性染色主要位于瘢痕基底部真皮深层与正常皮下组织交界处 ,呈团状 ,表明这些部位存在汗腺分泌部。K14的阳性染色散见于瘢痕组织中 ,呈同心圆状 ,为汗腺的导管部。 结论 严重烧伤后创面存在汗腺再生的生物学基础和潜力。在增生性瘢痕中之所以没有汗腺的重建 ,可能与瘢痕组织修复速度超过汗腺再生的速度或增生性瘢痕在创面形成一个屏障 ,阻碍了汗腺的再生有关。这可能是瘢痕组织愈合后创面缺乏汗腺和无排汗功能的重要原因之一
Objective To investigate the effect of scar formation on the regeneration of sweat glands. Methods Large area deep burn wounds and healthy skin tissues were collected from children and adults respectively. Immunohistochemistry was used to detect the expression of K19 and K14 in the scar tissue and the secretion of sweat glands Department of expression, and to determine the location and distribution of sweat glands in the scar tissue. At the same time, HE staining was used to observe the distribution of sweat gland in normal skin tissue. Results Normal sweat gland structure was observed in normal skin, including sweat gland secretion and ductus. The positive expression signals of K19 and K14 were found in the scar tissue. The positive staining of K19 mainly located in the deep dermis of the scar base and the junction of the normal subcutaneous tissue in the form of lumps, indicating that the sweat gland secretion part exists in these parts. Positive staining of K14 found in scar tissue, was concentric, is the duct of sweat glands. Conclusion The biological basis and potential of sweat gland regeneration in severe burn wounds exist. The lack of reconstruction of sweat glands in hypertrophic scars may be related to the speed at which scar tissue repairs faster than sweat gland regeneration or hypertrophic scars form a barrier on the wound, hindering the regeneration of sweat glands. This may be one of the major causes of scarless sweat glands and perspiration-free function in wounds after healing of scar tissue