法医学杂志

法医学杂志 ›› 2019, Vol. 35 ›› Issue (2): 149-153.DOI: 10.12116/j.issn.1004-5619.2019.02.004

所属专题： 损伤时间推断

• 专题 • 上一篇    下一篇

糖尿病损伤愈合期间中性粒细胞及肌成纤维细胞数量与损伤时间的关系

黄俊杰1，2，3， 姚艺1，2，3， 夏崇建1，2，3， 赵雅頔1，2，3， 余思1，2，3， 高原1，2，3， 叶光华1，2，3， 喻林升1，2，3， 范琰琰1，2，3   

  1. 1. 温州医科大学法医学系，浙江 温州 325035； 2. 温州医科大学司法鉴定中心，浙江 温州 325035； 3. 温州医科大学司法鉴定科学技术研究所，浙江 温州 325035
  • 发布日期:2019-04-25 出版日期:2019-04-28
  • 通讯作者: 范琰琰，男，副教授，主要从事皮肤创口愈合机制及损伤时间推断的研究；E-mail：fyy180000@126.com
  • 作者简介:黄俊杰（1992—），男，硕士研究生，主要从事糖尿病损伤愈合的研究；E-mail：963178186@qq.com
  • 基金资助:
    国家自然科学基金资助项目（81301640）；浙江省自然科学基金资助项目（Q19H090045，LQ13H150002）；上海市法医学重点实验室（司法鉴定科学研究院）资助项目（KF1805）；温州医科大学基础研究发展课题资助项目（QTJ17021）

Relationship between the Number of Neutrophils and Myofibroblasts during Diabetic Wound Healing and Wound Age

HUANG Jun-jie1,2,3, YAO Yi1,2,3, XIA Chong-Jian1,2,3, ZHAO Ya-di1,2,3, YU Si1,2,3, GAO Yuan1,2,3, YE Guang-hua1,2,3, YU Lin-sheng1,2,3, FAN Yan-yan1,2,3   

  1. 1. Department of Forensic Medicine, Wenzhou Medical University, Wenzhou 325035, Zhejiang Province, China; 2. Judical Forensic Center, Wenzhou Medical University, Wenzhou 325035, Zhejiang Province, China; 3. Institute of Forensic Science, Wenzhou Medical University, Wenzhou 325035, Zhejiang Province, China
  • Online:2019-04-25 Published:2019-04-28

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摘要： 目的 观察糖尿病损伤愈合期间中性粒细胞及肌成纤维细胞数量的时序性变化，初步探讨其对糖尿病损伤形成时间推断的应用价值。 方法 选取糖尿病组DB小鼠及其相同周龄的正常对照组小鼠，建立损伤愈合模型，提取伤后不同时间点的损伤样本，应用免疫组织化学染色技术观察创口愈合期间中性粒细胞及肌成纤维细胞的数量。 结果 对照组和糖尿病组创口浸润的中性粒细胞数量分别于伤后12 h和5 d达到峰值。与对照组相比，糖尿病组创口的中性粒细胞数量在伤后6 h~1 d显著减少，伤后5~14 d显著增多。伤后5~10 d，糖尿病组创口每个高倍视野的中性粒细胞平均数量大于30，而对照组创口的中性粒细胞平均数量小于20。肌成纤维细胞出现于伤后3~14 d的对照组创口及伤后5~14 d的糖尿病组创口。对照组和糖尿病组创口的肌成纤维细胞数量在伤后3~7 d差异有统计学意义（P<0.05）。 结论 与正常小鼠的损伤愈合相比，糖尿病小鼠的损伤愈合期间中性粒细胞及肌成纤维细胞数量呈现不同的时序性变化。本研究数据可为严重糖尿病患者的损伤形成时间推断提供参考。

关键词: 法医病理学, 糖尿病, 伤口愈合, 中性粒细胞, 肌成纤维细胞, 损伤时间推断, 小鼠

Abstract: Objective To investigate the sequential changes of the number of neutrophils and myofibroblasts during diabetic wound healing, and discuss its application value in wound age estimation. Methods Diabetic DB mice and mice of the same age in the normal control group were selected, a wound healing model was established, wound samples were taken at different time points, while the number of neutrophils and myofibroblasts during diabetic wound healing were determined by immunohistochemical staining technique. Results The number of infiltrated neutrophils in the wounds of control and diabetic groups reached the peak respectively at 12 h and 5 d after injury. Compared with the control group, the number of neutrophils in the diabetic group decreased significantly from 6 h to 1 d after injury, but increased markedly from 5 d to 14 d. From 5 d to 10 d after injury, the average number of neutrophils at high magnification in wounds of the diabetic group was over 30, while that of neutrophils in wounds of the control group was less than 20. Myofibroblasts appeared in wounds from 3 d to 14 d after injury in the control group and from 5 d to 14 d after injury in the diabetic group. The difference in the number of myofibroblasts in wounds between control group and diabetic group from 3 to 7 d after injury had statistical significance. Conclusion In comparison with normal wound healing, the number of neutrophils and myofibroblasts during diabetic wound healing shows different sequential changes. The results of this study can provide reference for wound age estimation of patients with severe diabetes.

Key words: forensic pathology, diabetes mellitus, wound healing, neutrophil, myofibroblast, wound age estimation, mice