《中国康复理论与实践》

《中国康复理论与实践》 ›› 2015, Vol. 21 ›› Issue (08): 921-923.

• 特稿 • 上一篇    下一篇

神经在皮肤创伤再生和瘢痕愈合中的作用

张瑾，解扬子，张选奋   

  1. 兰州大学第二医院整形外科，甘肃兰州市730030。作者简介：张瑾(1975-)，女，汉族，甘肃天水市人，主治医师，主要研究方向：皮肤创伤再生与瘢痕愈合。通讯作者：张选奋，男，医学博士，教授，博士研究生导师，主要研究方向：皮肤创伤再生与瘢痕愈合。E-mail：zhxf9304@126.com。
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2015-08-25 发布日期:2015-08-25

Roles of Nerve in Regeneration and Scar Healing of SkinWound (review)

ZHANG Jin, XIE Yang-zi, ZHANG Xuan-fen   

  1. Department of Plastic Surgery, the Second Hospital of Lanzhou University, Lanzhou, Gansu 730030, China
  • Received:1900-01-01 Revised:1900-01-01 Published:2015-08-25 Online:2015-08-25

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摘要： 神经是皮肤感觉和体温调节等生理功能的基础，也通过多种机制调控创伤再生和瘢痕愈合等病理过程。尽管失神经支配的皮肤伤口能够愈合，但神经通过启动神经源性炎症反应和神经营养作用增加伤口周围组织的血供，促进成纤维细胞和角质形成细胞增殖和Ⅰ型、Ⅲ型胶原的表达，与免疫系统的相互作用和释放神经肽等机制促进皮肤伤口愈合。如果各种参与修复细胞、细胞外基质、神经血管和皮肤附属器能有机装配则再生修复，否则瘢痕愈合。神经自身主要在创伤修复早期和瘢痕塑形期通过轴突的生长修复，其生长速度明显较肉芽组织形成和瘢痕化慢。而且，不同神经纤维的轴突生长也不完全相同。外源性神经肽可促进难愈性伤口愈合，神经肽拮抗剂或高选择神经切断等失神经措施可减轻瘢痕增生。因此，了解神经和各种修复成分在创伤再生修复与瘢痕愈合中的作用和调控机制，有助于寻找促进皮肤和周围神经损伤再生修复的方法。

关键词: 皮肤创伤, 神经, 再生, 瘢痕愈合, 综述

Abstract: Nerve is the foundation of the physiological function such as the skin feeling and thermoregulation, and also regulates the regeneration and scar healing of skin wound by multiple mechanisms. Though the denervated skin wound can heal spontaneously, the nerve might accelerate wound healing by activating the neurogenic inflammation and nerve trophism, increasing the blood supply around the wound, promoting the proliferation of fibroblasts and keratinocytes, stimulating the expression of collagen I and III, and interacting with immune system and releasing neuropeptides. If all kinds of repair cells, extracellular matrix, nerve, blood vessel and cutaneous appendages assemble organically, the skin wound regenerates, and otherwise the scar heals. The nerve axon growth occurs mainly in the early stage of the wound healing and the scar rebuilding process, and the nerve growth rate is obviously slower than the granulation tissue formation and cicatrization. Furthermore, the axon growth of different nerve fibers are not entirely the same. The exogenous neuropeptides might promote the wound repair and the nerve regeneration. The antagonist of the neuropeptides or high selective nerve abscission might reduce the scar hyperplasia. Therefore, it contribute to find methods to promote the regeneration of skin wound and peripheral nerve injury by understanding the effects and regulatory mechanism of both nerve and various repair elements in regeneration or scar healing of skin wound.

Key words: skin wound, nerve, regeneration, scar healing, review