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  本文選題：法舒地爾 + 增生性瘢痕��； 參考：《瀘州醫(yī)學(xué)院》2012年碩士論文

【摘要】：目的：本實驗通過對兔耳形成的增生性瘢痕內(nèi)分別注射鹽酸法舒地爾注射液（Fasudil Hydrochloride Injection，F(xiàn)HI）、醋酸曲安奈德注射液（TriamcinoloneAcetonaideAcetate Injection，TAAI）以及生理鹽水（Normal Saline,NS），從大體及組織病理學(xué)的角度，對各組增生性斑塊的瘢痕增生指數(shù)（Hypertrophic Index，HI）、成纖維細(xì)胞數(shù)量（Fibroblast Index，F(xiàn)BI）和對膠原纖維（Collagen fiber，CF）的形態(tài)、分布等各項指標(biāo)進行比對和統(tǒng)計分析，研究鹽酸法舒地爾注射液對增生性瘢痕組織的抑制作用。方法：健康標(biāo)準(zhǔn)化日本大耳兔12只，共24耳，雌雄各半，8-12月齡，體重2.0-2.5kg/只。氯胺酮1mg/kg肌注麻醉兔子后隨機分為3組，每組4只，在兔耳建立增生性瘢痕模型，每只兔耳造模4個，總計96個。實驗第28天隨機抽取1例增生性斑塊作病理切片染色證實增生性瘢痕形成，于每個增生性斑塊內(nèi)分別注射鹽酸法舒地爾、醋酸曲安奈德注射液和生理鹽水各30μl，分別于實驗第28天、第35天、第42天對各組兔耳增生性瘢痕模型內(nèi)進行注射，一共3次。觀察并記錄給藥過程中瘢痕的形狀、大小、質(zhì)地。其后在實驗第49天處死大耳兔，取兔耳增生性瘢痕組織的標(biāo)本進行HE染色和Masson染色，光鏡下觀察瘢痕組織成纖維細(xì)胞和膠原纖維的形態(tài)、分布等，同時鏡下通過測微尺計算各組標(biāo)本中瘢痕增生指數(shù)，目測切片標(biāo)本中成纖維細(xì)胞計數(shù)。實驗結(jié)果均采用PASW Statistics18（SPSS18.0）統(tǒng)計軟件對數(shù)據(jù)和圖片進行統(tǒng)計學(xué)分析。結(jié)果：1、大體表現(xiàn)：生理鹽水組（NS組）瘢痕仍明顯攣縮并高于皮面，色深質(zhì)硬，皮下可捫及明顯結(jié)節(jié)，表面凹凸不平。鹽酸法舒地爾組（FH組）和醋酸曲安奈德組（TAA組）瘢痕組織略高于皮面，未見明顯攣縮，瘢痕顏色變淺，接近皮色，質(zhì)地變軟，皮下結(jié)節(jié)小，兩組間瘢痕萎縮程度差異不明顯。2、切片光鏡下HE染色可見生理鹽水組（NS組）毛細(xì)血管增生明顯，成纖維細(xì)胞密集，核大深染，淺部呈漩渦狀排列，深部則于軟骨平行排列。膠原纖維排列雜亂，部分呈旋渦狀；鹽酸法舒地爾組（FH組）和醋酸曲安奈德組（TAA組）切片標(biāo)本較生理鹽水組（NS組）薄，表面平整，層次有序，可見毛細(xì)血管增生較生理鹽水組（NS組）不顯著，增生性組織內(nèi)可見成纖維細(xì)胞和少量炎性細(xì)胞浸潤，成纖維細(xì)胞細(xì)長。鹽酸法舒地爾組（FH組）和醋酸曲安奈德組（TAA組）成纖維細(xì)胞胞核未見明顯增大，細(xì)胞排列較緊密且比較有序，，數(shù)量較生理鹽水組（NS組）減少，呈疏松狀有序排列。膠原纖維較生理鹽水組（NS組）規(guī)則排列。3、Masson染色下可見生理鹽水組（NS組）膠原纖維藍(lán)染較深，細(xì)胞間分布紊亂，生理鹽水組（NS組）中粗大的膠原纖維藍(lán)染較鹽酸法舒地爾組（FH組）和醋酸曲安奈德組（TAA組）顏色更深，鹽酸法舒地爾組（FH組）和醋酸曲安奈德組（TAA組）膠原纖維則淡染，纖細(xì)，疏松分布排列整齊。鹽酸法舒地爾組（FH組）和醋酸曲安奈德組（TAA組）兩組間比較膠原纖維形態(tài)、分布、染色等未見明顯差異。4、生理鹽水組（NS組）瘢痕增生指數(shù)（HI）以及成纖維細(xì)胞計數(shù)（FBI）均高于鹽酸法舒地爾組（FH組）和醋酸曲安奈德組（TAA組），兩兩組間差異有統(tǒng)計學(xué)意義（P0.05）；鹽酸法舒地爾組（FH組）和醋酸曲安奈德組（TAA組）兩組間相比，鹽酸法舒地爾組（FH組）和醋酸曲安奈德組（TAA組）瘢痕增生指數(shù)無顯著性差異（P＞0.05），鹽酸法舒地爾組（FH組）成纖維細(xì)胞計數(shù)高于醋酸曲安奈德組（TAA組），兩兩組間差異有統(tǒng)計學(xué)意義（p0.05），認(rèn)為TAAI對成纖維細(xì)胞的抑制作用較FHI顯著。結(jié)論：鹽酸法舒地爾注射液（鈣離子拮抗劑）及醋酸曲安奈德溶液（腎上腺皮質(zhì)激素）對兔耳增生性瘢痕均有明顯抑制作用，可見瘢痕組織變軟、變平，醋酸曲安奈德溶液（TAAI）對成纖維細(xì)胞的抑制作用較鹽酸法舒地爾注射液（FHI）更為明顯，鹽酸法舒地爾組（FH組）和醋酸曲安奈德組（TAA組）兔耳增生性瘢痕組織的瘢痕增生指數(shù)（HI）并無明顯差異，二者對兔耳增生性瘢痕組織的膠原纖維無顯著差異性影響。本實驗認(rèn)為，鹽酸法舒地爾注射液（FHI）作為新型鈣離子拮抗劑，可作為臨床治療增生性瘢痕的另一安全有效的治療藥物的選擇，可為增生性瘢痕的治療提供了一種新的思路和方法。
[Abstract]:Objective: in this experiment, Fasudil Hydrochloride Injection (Fasudil Hydrochloride Injection, FHI), Triamcinolone Acetonide Acetate Injection (TriamcinoloneAcetonaideAcetate Injection, TAAI) and physiological saline (Normal Saline, NS) were injected into the hypertrophic scar formed in the rabbit ear, and all the groups were increased from the general and histopathological point of view. The index of Hypertrophic Index (HI), the number of fibroblasts (Fibroblast Index, FBI) and the morphology and distribution of collagen fiber (Collagen fiber, CF) and other indexes were compared and statistically analyzed to study the inhibitory effect of Fasudil Hydrochloride Injection on hypertrophic scar tissue. Methods: healthy standardization of Japan. 12 rabbits with 24 ears, male and male, and male and male, and male and male, 8-12 months old, weight 2.0-2.5kg/ only. After anaesthetized rabbits with ketamine 1mg/kg intramuscular anaesthesia, 3 groups were randomly divided into 4 rats in each group. The model of hypertrophic scar was established in rabbit ears, 4 of each rabbit ear, total of 96. The experimental twenty-eighth days randomly selected 1 hypertrophic plaques for pathological section staining to prove hypertrophic scar formation, In each hyperplastic plaque, FFD, Triamcinolone Acetonide Acetate Injection and normal saline were 30 l each, respectively, in the twenty-eighth days, thirty-fifth days, and forty-second days of the rabbit ear hypertrophic scar model, respectively, 3 times. The shape, size and texture of the scar were observed and recorded in the forty-ninth days of the experiment. HE staining and Masson staining were taken for the specimens of hypertrophic scar tissue of rabbit ears. The morphology and distribution of fibroblasts and collagen fibers in scar tissue were observed under light microscope. At the same time, the index of hypertrophic scar hyperplasia was calculated by micrometer, and the count of fibroblast in the specimens of the specimens were counted. The results of the experiment were all PASW Stat Statistical analysis of istics18 (SPSS18.0) statistics software on the data and pictures. Results: 1, gross performance: the scar in the physiological saline group (group NS) is still markedly contracture and higher than the skin surface, the color is deep and hard, the subcutaneous can be palpable and the obvious nodule, the surface is uneven. The scar tissue of the famudil group (group FH) and the triamcinolone acetate group (group TAA) is slightly higher than the skin. Face, no obvious contracture, scar color light, close to skin color, texture soft, subcutaneous nodule small, the degree of scar atrophy between the two groups is not obvious difference between the two groups, HE staining under the microscope visible saline group (group NS) capillary hyperplasia, dense fibroblast cells, large deep dye, shallow vortex like arrangement, the deep cartilage in parallel arrangement. Glue. The primary fibers were arranged in a disorder and part of the whirlpool. The sliced specimens of the fasudil group (group FH) and triamcinolone acetate (group TAA) acetate (group NS) were thinner than the saline group (group NS), the surface was flat and orderly, and the capillary hyperplasia was not significant in the saline group (group NS), and the fibroblasts and a small amount of inflammatory cells infiltrated in the proliferative tissue. Fibrous cells were slender. The nuclei of fibroblasts in group FH and triamcinolone acetate (group TAA) were not significantly increased, and the cells were arranged closely and orderly. The number of cells in the saline group (group NS) decreased and arranged in a loose and orderly arrangement. The collagen fibers were arranged in a regular arrangement of.3 in the saline group (group NS), and the physiology was observed under Masson staining. The collagen fibers in the saline group (group NS) were dyed deeply, and the distribution of the cells was disordered. The thick collagen fiber blue dye in the saline group (group NS) was more darker than the FFD group (group FH) and the triamcinolone acetate group (group TAA). The collagen fibers in the famudil group (group FH) and the triamcinolone acetate group (group TAA) were pale, thin and loosely distributed. There was no significant difference in collagen fiber morphology, distribution and staining between the two groups (group FH) and triamcinolone acetate group (group TAA). The scar proliferation index (HI) and fibroblast count (FBI) in the saline group (group NS) were higher than that of the FFD group (group FH) and the triamcinolone acetate group (TAA group), and the difference between the 22 groups was poor. There was no statistically significant difference (P0.05); there was no significant difference between the two groups (group FH) and triamcinolone acetate (group TAA) group (group FH) and triamcinolone acetate group (group TAA) with no significant difference (P > 0.05), and the count of fibroblasts in group FH (group FH) was higher than that of triamcinolone acetate (TAA group). The difference between the 22 groups was statistically significant (P0.05), and the inhibitory effect of TAAI on fibroblasts was more significant than that of FHI. Conclusion: Fasudil Hydrochloride Injection (calcium antagonist) and triamcinolone acetate solution (adrenocortical hormone) have obvious inhibitory effect on hypertrophic scar of rabbit ears. It can be seen that the scar tissue softened, leveled, and acetamide acetate. The inhibitory effect of TAAI on fibroblasts was more obvious than that of Fasudil Hydrochloride Injection (FHI). There was no significant difference in scar proliferation index (HI) in the hypertrophic scar tissue of rabbit ear hydrochloric acid group (group FH) and triamcinolone acetate (TAA group). There was no significant difference between the two of the collagen fibers in the hypertrophic scar tissue of rabbit ears. This experiment suggests that Fasudil Hydrochloride Injection (FHI), as a new type of calcium ion antagonist, can be used as another safe and effective therapeutic drug for clinical treatment of hypertrophic scar. It can provide a new way of thinking and method for the treatment of hypertrophic scar.
【學(xué)位授予單位】：瀘州醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2012
【分類號】：R965;R758.6

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本文編號：1912950