本文選題：局灶性光熱作用　切入點(diǎn)：膠原重建　出處：《上海交通大學(xué)》2012年博士論文　論文類型：學(xué)位論文

【摘要】：局灶性光熱作用是一種新型的激光照射方法，通過點(diǎn)陣激光燒蝕部分皮膚，修復(fù)和重建皮膚表層和真皮層，達(dá)到激光美容的療效。與傳統(tǒng)激光美容方法相比，它減少了水腫、瘢痕、紅斑或色素變化等不良反應(yīng)，也克服了非剝脫性激光治療時一次照射效果不佳的弱點(diǎn)。局灶性光熱作用通過點(diǎn)陣狀的微治療孔誘發(fā)熱損傷后的皮膚修復(fù)和膠原重建，這一復(fù)雜過程涉及諸多細(xì)胞和生長因子，但由于人體取材的限制，組織學(xué)發(fā)展過程還沒有得到系統(tǒng)的定量分析，具體的調(diào)控機(jī)制也沒有明確。明確局灶性光熱作用下膠原重建的特征和機(jī)理，可以為點(diǎn)陣激光的皮膚學(xué)臨床應(yīng)用提供有價(jià)值的實(shí)驗(yàn)依據(jù)和理論基礎(chǔ)。 針對局灶性光熱作用基礎(chǔ)研究的現(xiàn)狀和存在問題，我們建立小鼠模型進(jìn)行了系統(tǒng)的研究。通過對生物物理學(xué)特性的測量，首先對照比較了局灶性光熱作用和傳統(tǒng)剝脫性及非剝脫性激光在膠原重建過程中對皮膚表面結(jié)構(gòu)功能的影響的異同之處；在了解這種作用模式的治療特點(diǎn)后，進(jìn)一步通過HE染色、雙重染色、免疫組化、酶聯(lián)免疫法等多種手段揭示局灶性光熱作用后皮膚修復(fù)和膠原重建的組織學(xué)特點(diǎn)，特別定量分析了成纖維細(xì)胞增殖和膠原重建的變化情況；最終通過定量地評價(jià)和比較膠原重建過程中生長因子VEGF、TGF-β1和bFGF表達(dá)水平的變化，與皮膚組織學(xué)特征相聯(lián)系，揭示局灶性光熱作用誘導(dǎo)皮膚修復(fù)和膠原重建過程中的細(xì)胞及生長因子調(diào)控機(jī)制。 實(shí)驗(yàn)結(jié)果發(fā)現(xiàn)，相對于傳統(tǒng)的激光治療，局灶性光熱作用誘導(dǎo)膠原重建過程中可有效改善皮膚彈性值，而皮膚紅斑值、黑素值等不良反應(yīng)表現(xiàn)輕微，代表皮膚屏障功能的經(jīng)皮失水量和皮膚含水量都顯示了安全性，從皮膚表面結(jié)構(gòu)和功能上肯定了局灶性光熱作用的有效性和安全性，，這項(xiàng)新技術(shù)臨床應(yīng)用前景令人期待。局灶性光熱作用的皮膚組織學(xué)表現(xiàn)為點(diǎn)陣狀的熱損傷和可控性的修復(fù)，有效刺激了成纖維細(xì)胞和膠原的增生，早期增生膠原以Ⅲ型為主，中后期以Ⅰ型為主，總量上以Ⅰ型為主，推測局灶性光熱作用后的膠原重建以Ⅰ型膠原增生為主，揭示了局灶性光熱作用的膠原重建特點(diǎn)。最為重要的是，實(shí)驗(yàn)結(jié)果顯示VEGF、TGF-β1和bFGF等關(guān)鍵生長因子在不同的修復(fù)階段起著重要作用，推測其中VEGF在修復(fù)早期起作用，TGF-β1和bFGF在整個修復(fù)過程中起作用，TGF-β1和其他兩個生長因子可能存在相互影響，它們的主要作用與刺激成纖維細(xì)胞增殖和促進(jìn)膠原重建有關(guān)。 本研究系統(tǒng)地評價(jià)和分析了局灶性光熱作用在動物模型中對皮膚組織的確切療效和作用機(jī)制，為局灶性光熱作用這一技術(shù)在皮膚科臨床上的應(yīng)用提供了理論基礎(chǔ)和實(shí)驗(yàn)依據(jù)。
[Abstract]:Focal photothermia is a new type of laser irradiation method, which uses dot array laser ablation of part of the skin, repair and reconstruction of the skin surface and dermis to achieve the therapeutic effect of laser cosmetology. Compared with the traditional laser cosmetic method, it reduces edema. Adverse reactions, such as scar, erythema or pigment changes, also overcome the weakness of a single irradiation effect during non-stripping laser therapy. Focal photothermia induces skin repair and collagen reconstruction after thermal injury through a lattice of microtherapeutic holes. This complex process involves many cells and growth factors, but the histologic development process has not been systematically analyzed because of the limitations of the human body's selection of materials. The characteristics and mechanism of collagen reconstruction under focal photothermia can provide valuable experimental and theoretical basis for the clinical application of lattice laser dermatology. In view of the present situation and existing problems in the basic research of focal photothermal action, we have established a mouse model for systematic study, which is based on the measurement of biophysical properties. Firstly, the effects of focal photothermal action on skin surface structure and function during collagen reconstruction were compared with those of traditional exfoliation and non-stripping laser. The histological features of skin repair and collagen reconstruction after focal photothermia were revealed by HE staining, double staining, immunohistochemistry and enzyme linked immunosorbent assay (Elisa). In particular, the changes of fibroblast proliferation and collagen reconstruction were quantitatively analyzed, and the changes of the expression levels of VEGF TGF- 尾 1 and bFGF during collagen reconstruction were quantitatively evaluated and compared, which were related to the histological characteristics of skin. To explore the regulation mechanism of cell and growth factor during skin repair and collagen reconstruction induced by focal photothermia. The results showed that compared with the traditional laser therapy, focal photothermia induced collagen reconstruction could effectively improve the skin elasticity, while the skin erythema value, melanin value and other adverse reactions showed slight. Both skin water loss and skin moisture content, which represent skin barrier function, are safe. The effectiveness and safety of focal photothermal action are confirmed from skin surface structure and function. The prospect of clinical application of this new technique is promising. The skin histology of focal photothermia is characterized by lattice thermal damage and controllable repair, which effectively stimulates the proliferation of fibroblasts and collagen. In the middle and late stage, type I was the main type, and the total amount was type 鈪

本文編號：1619683