【摘要】 目的探讨细菌胶原酶治疗增生性瘢痕及瘢痕疙瘩的作用机理;观测评价其临床疗效。方法通过动物实验对细菌胶原酶降解增生性瘢痕的作用进行验证,并通过10个病例对其临床疗效进行初步观察。结果动物实验显示,两次注药后,两周内瘢痕块体积平均缩小86%,较对照组差异有非常显著意义(P<0.001)。临床观察显示,经过两次病灶内细菌胶原酶的注射(剂量200～2000U),瘢痕体积两周内平均缩小46.92%,其中有4例缩小50%以上,占病例总数的30%。经过对5名病人3～16个月随访,除1例瘢痕疙瘩于治疗后第2个月复发外,余均无复发迹象。胶原酶作用后的瘢痕组织,光镜及电镜下可以清楚地看到处于溶解状态的胶原结构。结论细菌胶原酶可以直接降解瘢痕组织内的胶原纤维,可望成为一种快速有效的治疗增生性瘢痕和瘢痕疙瘩的新方法。更多还原

【Abstract】 Objective To investigate the mechanism of collagenase in degradation of hypertrophic scars and observe the clinical effects of this therapy.Methods Both animal experiment and clinical trial were conducted.Results The injection of collagenase into the hypertrophic scar tissues in nude mice re- sulted in 86% volume reduction after two injections within two weeks,while the control tissues reduced only by 35% during the same time.Clinically,13 cases were treated with intralesional injection of bacterial collagenase.The volume reduction rate was 46.92% in average within two weeks.The volume reduction in 4 of 13 cases was above 50%.Three to sixteen months’ follow-up of five patients revealed that only one case of keloid recurred after treatment in the second month.Examinations of histological sections and TEM showed the dissolved collagen fiber clearly.Conclusion Collagenase can degrade collagen fiber directly. The prompt significant effects and the mild complications make it a prospective therapy.更多还原