本文關(guān)鍵詞：抑郁復(fù)合皮膚創(chuàng)傷對(duì)大鼠創(chuàng)面愈合的影響　出處：《第三軍醫(yī)大學(xué)》2007年碩士論文　論文類(lèi)型：學(xué)位論文

  更多相關(guān)文章： 動(dòng)物模型 創(chuàng)面愈合 抑郁 毛細(xì)血管 成纖維細(xì)胞 羥脯氨酸 Ⅰ/Ⅲ型膠原

【摘要】： 隨著社會(huì)的不斷進(jìn)步和醫(yī)學(xué)的迅速發(fā)展,人類(lèi)許多疾病已逐步得到有效的控制,但創(chuàng)傷卻隨著現(xiàn)代文明的發(fā)展不斷增多,圍繞創(chuàng)面愈合的研究也成為創(chuàng)傷外科和軍事醫(yī)學(xué)領(lǐng)域中備受關(guān)注的問(wèn)題之一。皮膚是機(jī)體防御外界刺激和損傷的第一道屏障,在絕大部分創(chuàng)傷中都會(huì)有皮膚損傷存在,因而,皮膚的創(chuàng)面愈合與組織修復(fù)成為近年創(chuàng)傷研究中最具潛力和引人注目的部分。 多年來(lái),創(chuàng)傷研究工作者運(yùn)用組織病理學(xué)、生物化學(xué)、藥物學(xué)、生物材料學(xué),以及外科學(xué)等手段對(duì)創(chuàng)面修復(fù)的過(guò)程、發(fā)生機(jī)制、臨床治療等多方面進(jìn)行了較深入的研究,取得了一定成就。然而,由于創(chuàng)面愈合是一個(gè)非常復(fù)雜的生物學(xué)過(guò)程,創(chuàng)面的愈合時(shí)間和修復(fù)程度既與損傷程度和組織再生能力有關(guān),也受機(jī)體全身和局部條件的影響。目前,人們不僅已對(duì)感染、缺血、缺氧、營(yíng)養(yǎng)不良、激素及抗腫瘤藥等對(duì)創(chuàng)面愈合的影響進(jìn)行了深入探討,而且也已深刻認(rèn)識(shí)到某些疾病如放射病、糖尿病等在慢性難愈性創(chuàng)面發(fā)生發(fā)展過(guò)程中的作用,特別是近年國(guó)內(nèi)外學(xué)者在放創(chuàng)復(fù)合傷研究領(lǐng)域取得了一系列突破性研究成果,標(biāo)志著創(chuàng)面修復(fù)的研究獲得了突飛猛進(jìn)的發(fā)展。但臨床觀察發(fā)現(xiàn),同樣傷型,相似生理?xiàng)l件的傷者,其傷口愈合時(shí)間可差別較大,有的甚至成為難愈性創(chuàng)傷。因此,迄今為止,創(chuàng)傷難愈的原因仍未完全闡明。 隨著醫(yī)學(xué)模式的轉(zhuǎn)變,心理因素對(duì)健康的影響已得到人們的公認(rèn)。由于生活節(jié)奏的加快和社會(huì)競(jìng)爭(zhēng)的加劇,近年抑郁癥的發(fā)病率正快速攀升。世界大型流行病學(xué)研究顯示,抑郁癥目前在世界致殘性疾病中排名第四,估計(jì)到2020年,抑郁將成為世界第二大健康負(fù)擔(dān),成為僅次于心臟病的世界第二“殺手”。因此,抑郁癥受到臨床心理學(xué)及醫(yī)學(xué)界的高度重視,它對(duì)人類(lèi)身體健康構(gòu)成的巨大威脅也引起了人們的廣泛關(guān)注。臨床觀察發(fā)現(xiàn),抑郁、焦慮患者創(chuàng)傷愈合時(shí)間可4倍于正常人群;在難愈性創(chuàng)傷中,患者常常伴有明顯的抑郁情緒。由此,我們假設(shè)心理因素,特別是抑郁可能是影響皮膚創(chuàng)面愈合的重要原因之一。但目前國(guó)內(nèi)外這方面的研究報(bào)道極少,且已有研究基本局限在臨床觀察方面,采用的研究手段也多為調(diào)查性研究,國(guó)內(nèi)外相應(yīng)的實(shí)驗(yàn)性研究均十分少見(jiàn),對(duì)其影響機(jī)制更缺乏系統(tǒng)研究。為此,本課題擬通過(guò)實(shí)驗(yàn)性研究手段,以大鼠為實(shí)驗(yàn)對(duì)象,探討抑郁復(fù)合皮膚創(chuàng)傷對(duì)創(chuàng)面愈合的影響,以期為復(fù)合傷中軀體損傷復(fù)合心理?yè)p傷的防治提供理論和實(shí)踐依據(jù)。研究共分兩部分進(jìn)行:①首先建立抑郁復(fù)合皮膚創(chuàng)傷動(dòng)物模型,并對(duì)該模型的有效性和可行性進(jìn)行評(píng)價(jià);②在成功建立動(dòng)物模型的基礎(chǔ)上,觀察抑郁復(fù)合皮膚創(chuàng)傷對(duì)創(chuàng)面愈合的影響,并初步探討其影響創(chuàng)面愈合的機(jī)制,得到主要結(jié)果如下: 1.通過(guò)慢性輕度不可預(yù)見(jiàn)性刺激結(jié)合孤養(yǎng)并機(jī)械致皮膚創(chuàng)傷,經(jīng)曠場(chǎng)實(shí)驗(yàn)、液體消耗實(shí)驗(yàn)等證實(shí),該模型不僅能較好地模擬人類(lèi)抑郁癥的諸多癥狀,且復(fù)合全層皮膚缺損,是一個(gè)理想的抑郁復(fù)合皮膚創(chuàng)傷動(dòng)物模型,為開(kāi)展相關(guān)研究奠定了基礎(chǔ)。 2.無(wú)論抑郁復(fù)合皮膚創(chuàng)傷,還是皮膚創(chuàng)傷復(fù)合抑郁,都可顯著延緩創(chuàng)面的愈合速度及愈合時(shí)間。其中抑郁復(fù)合皮膚創(chuàng)傷大鼠的創(chuàng)面愈合時(shí)間為19~24天,平均(22.17±1.72)天;皮膚創(chuàng)傷復(fù)合抑郁大鼠的創(chuàng)面愈合時(shí)間為19~25天,平均(23.00±2.28)天;單純皮膚創(chuàng)傷組大鼠的創(chuàng)面愈合時(shí)間為16~19天,平均(17.50±1.38)天。說(shuō)明抑郁是造成創(chuàng)傷難愈不容忽視的因素之一。 3.在觀察到抑郁復(fù)合皮膚創(chuàng)傷顯著延緩大鼠皮膚創(chuàng)面愈合的基礎(chǔ)上,我們通過(guò)形態(tài)學(xué)和免疫組化等方法進(jìn)一步探討了其影響創(chuàng)面愈合的機(jī)制,發(fā)現(xiàn):抑郁復(fù)合皮膚創(chuàng)傷大鼠創(chuàng)面局部毛細(xì)血管的生成受抑制、成纖維細(xì)胞減少、膠原合成速度延緩、羥脯氨酸合成量減少,從而影響創(chuàng)面肉芽組織的生成數(shù)量和質(zhì)量,造成創(chuàng)面愈合延遲。
[Abstract]:With the rapid development of society and the progress of medicine, many human diseases have been effectively controlled, but the trauma is increasing with the development of modern civilization, the study of wound healing has become a concern in trauma surgery and military medicine problems. The skin is the first barrier to external stimulation and injury the most of traumas involve skin injury. Therefore, skin wound healing and tissue repair trauma research in recent years become a promising and attractive part.
Over the years, trauma researchers by histopathology, biochemistry, pharmacology, biological materials, mechanism and process of surgery of wound repair, in-depth clinical treatment and other aspects, has made some achievements. However, because of the wound healing is a complex biological process and the ability of wound healing time and degree of repair and degree of injury and regeneration, but also affected by systemic and local conditions. At present, people not only have the infection, ischemia, hypoxia, malnutrition, hormone and anti tumor drugs were studied on the wound healing effect, but also has a profound understanding to some diseases such as radiation disease, diabetes in pathogenesis of chronic wounds, especially in recent years, domestic and foreign scholars in the field of radiation combined wound and made a series of process Breaking of research results, marking the wound repair research has gained rapid development. But the clinical observation found that the same type of injury, similar to the physiological condition of the injured, the wound healing time can vary greatly, some even become refractory wounds. Therefore, so far, has not been fully elucidated. The reason of wound healing
With the transformation of medical model, effects of psychological factors on health has been widely recognized. Due to the accelerated pace of life and social competition in recent years, the incidence of depression is rising rapidly. World major epidemiologic study shows that depression at present in the world disabling disease ranked fourth, estimated that by 2020, depression will become the world's second the health burden of heart disease, become the second world second "killer". Therefore, depression is highly valued by the clinical psychology and medical field, it constitutes a great threat to human health has also aroused people's attention. The clinical observation that patients with anxiety, depression, wound healing time can be 4 times more than in normal people; refractory trauma, patients often accompanied by obvious depression. Thus, we hypothesize that psychological factors, especially depression may affect the skin wound healing One of the important reasons. But the current domestic and foreign research reports in this area is few, and the existing research is limited in clinical observation, the methods are mostly research and investigation, the corresponding experimental research at home and abroad are very rare, but the lack of systematic study on the influence mechanism. Therefore, this project intends to experimental study on means to rats as experimental objects, the effects of depression combined with skin injury on wound healing, in order to provide theoretical and practical basis for the prevention of injury in body injury combined with mental injury. The study is divided into two parts: firstly, the establishment of depression combined with skin injury animal model, and the effectiveness of the the model and the feasibility of the evaluation; the establishment of animal model of success, to observe the depression combined with skin injury on wound healing, and to explore the influence of the mechanism of wound healing, too The main results are as follows:
1. by chronic unpredictable mild stimulation combined with lonely feed and mechanically induced skin trauma, after the open field test, fluid consumption demonstrated that many symptoms of this model can not only simulate human depression, and the composite of full-thickness skin defect, is an ideal animal model of depression combined with skin injury, laid the foundation in order to carry out related research.
2. both the depression combined with skin trauma, or skin trauma combined with depression can significantly delay the speed of wound healing. The wounds of depression combined with rat skin wound healing time was 19~24 days, average (22.17 + 1.72) days; skin trauma combined with depression rats healing time was 19~25 days (average. 23 + 2.28) days; simple wound group rats skin wound healing time was 16~19 days, average (17.50 + 1.38) days. That depression is one of the factors causing the wound healing can not be ignored.
3. based on the observed depression combined with skin injury significantly delayed wound healing in rats, we used morphological and immunohistochemical methods to further explore the influencing mechanism of wound healing: depression combined with skin injury rat wound capillary into inhibited fibroblast collagen synthesis decreased, slow the pace, hydroxyproline synthesis was reduced, thus affecting the quantity and quality of granulation tissue formation, resulting in delayed wound healing.

【學(xué)位授予單位】：第三軍醫(yī)大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2007
【分類(lèi)號(hào)】：R395

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