黎丁菱+高彦晨+农晓琳

[摘要]目的 研究硅酮凝胶对小型猪瘢痕模型中血管内皮生长因子（VEGF）的影响，探讨医用硅酮凝胶的作用机制。方法 于2015年7～9月构建小型猪猪背瘢痕模型，随机分为空白对照组和硅酮凝胶组。硅酮凝胶组在术后28 d外用医用硅酮凝胶喷雾剂，空白对照组不作处理。术后56 d处死动物，切取猪背瘢痕，采用免疫组化的方法观察瘢痕中VEGF的变化情况。结果 硅酮凝胶组的瘢痕增生较空白对照组显著减轻。硅酮凝胶组的VEGF平均光密度值为0.034±0.081，显著低于空白对照组的0.110±0.014，差异有统计学意义（P<0.05）。结论 硅酮凝胶可能通过下调VEGF而减轻瘢痕的增生。

[关键词]瘢痕；硅酮凝胶；血管内皮生长因子；动物模型

[中图分类号] R-332 [文献标识码] A [文章编号] 1674-4721（2017）01（c）-0123-03

[Abstract]Objective To study the influence of Silicone Gel on the expression of vascular endothelial growth factor （VEGF） in scar model on the back of miniature pig and to explore the mechanism of action of medical Silicone Gel.Methods From July to September in 2015，the minipig back scar model was constructed and were randomly divided into the control group and the Silicone Gel group.The Silicone Gel group was given Medical Silicone Gel Spray after operation for 28 days，the control group was not treated.The animals were sacrificed after operation at 56 days，and the scar of pig back was removed.The changes of VEGF was observed by immunohistochemistry.Results Scar hyperplasia in the Silicone Gel group was significantly reduced，compared with the blank control group.The average optical density of VEGF in the Silicone Gel group was 0.034±0.081，which was lower than 0.110±0.014 in the the control group，with significant difference （P<0.05）.Conclusion Silicone Gel may reduce scar hyperplasia by down-regulation of VEGF.

[Key words]Scar；Silicone Gel；Vascular endothelial growth factor；Animal model

皮膚病理性瘢痕是创伤愈合过程中形成的一种皮肤纤维组织增生性疾病，包括增生性瘢痕（hypertrophic scar）和瘢痕疙瘩（keloid）。增生性瘢痕是临床上常见疾病，目前防治增生性瘢痕的方法很多，例如手术治疗、药物治疗和放射治疗等，但治疗效果并不十分理想，停止治疗后容易复发[1]。在分析病理性瘢痕发生机制的因素中，血管因素在瘢痕形成过程中的作用越来越受到重视。初步的研究显示，瘢痕的发生、发展、转归及预后与瘢痕组织的微血管形成及血管内皮生长因子（vascular endothelial growth factor，VEGF）等细胞因子过度表达紧密相关[2]。VEGF是目前已知的最强的促血管因子，具有促进细胞增殖、促进血管支持物生成等功能，且在病理性瘢痕中呈高度表达[3-4]。本研究通过建立小型猪增生性瘢痕模型，探讨硅酮凝胶喷雾剂对增生性瘢痕的作用机制及对VEGF表达的影响，为医用硅酮凝胶的应用提供理论依据。……