中文摘要：

目的探索增生性瘢痕在发生和演变过程中，微血管通透性改变及其意义。方法取患者不同时期增生性瘢痕组织和正常皮肤组织，进行微血管基底膜电镜观察。另外，建立裸鼠瘢痕埋植模型，将不同时期瘢痕和正常皮肤种植裸鼠皮下，4周后从裸鼠尾静脉注射伊文思蓝，取出瘢痕组织剪碎，检测伊文思蓝光密度值。结果电镜观察可见：与正常皮肤微血管比较，瘢痕演变过程中微血管管腔逐渐狭小，基底膜逐渐增厚。成熟期瘢痕见微血管、内皮细胞和基底膜结构大致接近正常。伊文思蓝检测结果发现：与正常皮肤通透性相比（0．85±0．21），早期和增生期瘢痕通透性逐步降低（0．63±0．16、0．38±0．08），消退期达到最低（0．13±0．04），成熟期有所升高（0．68±0．12）。结论增生性瘢痕发生和演变过程中，微血管通透性逐渐降低，可能引起瘢痕组织逐步加重的缺血缺氧改变。

英文摘要：

Objective To investigate the change of micro vascular permeability during scar formation and regression. Methods The human hypertrophic scars of different stages as early, proliferative, regressive and mature scars were harvested and processed for electronic microscopy. And some tissues were transplanted subcutaneously into the nude miee. Four weeks later, Evens＇ blue were injeeted by the tail vein, and harvested the scar tissue then minced it, the optical density （OD） value was detected under illuminometer. Results Electronic mieroseopy showed that with sear progression, the lumen of the mierovessels became narrower, and the basement membrane became thicker. The worst condition was seen in regressive sear. In mature sear, the condition improved. OD detection of tissue Evens＇ blue revealed that, when compared to normal skin （0.85 ± 0.21 ） ,the OD value reduced gradually in early scar and proliferative sear （0.63 ±0.16, 0.38 ±0.08）, and reached to the lowest level in regressive scar （0.13 ± 0.04） , and almost recovered in mature sear （0.68 ± 0.12）. Conclusion The micro vascular permeability drops during the sear progression, which may eause the mi change of fibroblast outside the micro vessel.