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目的 探讨肥厚性瘢痕的发生与成纤维细胞和血管内皮细胞凋亡的关系，以及有关调控因素的影响。 方法 应用原位末端标记和免疫组织化学染色等技术，对61例烧伤后整形患者肥厚性瘢痕和20例其他手术患者非肥厚性瘢痕进行了细胞凋亡以及ICE、Bcl-2表达的检测。 结果 肥厚性瘢痕增厚期、成熟期成纤维细胞以及血管内皮细胞凋亡阳性细胞指数分别为6.60±4.43和8.90±6.01，成熟期分别为25.60±5.70和26.60±6.02，两期同种细胞间相比，凋亡阳性细胞指数均有非常显著性差异（P＜0.01）。增厚期ICE阳性表达率较成熟期显著降低（P＜0.01），而Bcl-2阳性率却显著高于成熟期组（P＜0.01）。 结论 细胞凋亡减少可能与肥厚性瘢痕的形成有关，ICE和Bcl-2可能参与了肥厚性瘢痕成纤维细胞和血管内皮细胞凋亡的调控。
Objective To investigate the relationship between the occurrence of hypertrophic scars and the apoptosis of fibroblasts and vascular endothelial cells, and the influence of related regulatory factors. Methods Apoptosis and expression of ICE and Bcl-2 in hypertrophic scars in 61 cases of burn patients and non-hypertrophic scars in 20 cases of other surgeries were detected by in situ end labeling and immunohistochemical staining. Results The index of apoptotic cells in hypertrophic scar hypertrophy, mature fibroblasts and vascular endothelial cells were 6.60 ± 4.43 and 8.90 ± 6.01, respectively, and those in mature stage were 25.60 ± 5.70 and 26.60 ± 6.02, respectively There was a significant difference in apoptotic index (P <0.01). The positive expression rate of ICE in thickening stage was significantly lower than that in mature stage (P <0.01), while the positive rate of Bcl-2 was significantly higher than that in mature stage (P <0.01). Conclusions The decreased apoptosis may be related to the formation of hypertrophic scars. ICE and Bcl-2 may be involved in the regulation of hypertrophic scar fibroblasts and vascular endothelial cell apoptosis.