程洪伟 孙广慈 管正玉 张海明 北京，中国协和医科大学中国医学科学院整形外科医院 100041 中华整形烧伤外科杂志 1999 0 15 3


    关键词：增生性瘢痕；瘢痕疙瘩；细菌胶原酶；胶原降解 期刊 zhzxsswkzz 0 论 著 fur -->


    

【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200～2 000U)，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。

Experimental study and preliminary clinical application of bacterial collagenase in catabolizing scars

CHENG Hongwei,SUN Guangci,GUAN Zhengyu,et al.Plastic Surgery Hospital of Chinese Academy of Medical Sciences,Beijing 100041

【 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 resulted 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.

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