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1、皮膚損傷的修復(fù)修復(fù)repair再生Regeneration纖維性修復(fù)不能由再生修復(fù)的損傷，通過肉芽組織增生填補(bǔ)缺損并轉(zhuǎn)化為瘢痕組織的過程。肉芽組織Granulationtissue一、概念：Granulationtissue三、肉芽組織的功能3、填補(bǔ)連接傷口或其他缺損1、抗感染及保護(hù)創(chuàng)面2、機(jī)化血凝塊、壞死組織及其他異物健康肉芽不良肉芽四、肉芽組織的結(jié)局新生的毛細(xì)血管增生的纖維母細(xì)胞一定量的炎性細(xì)胞小動脈、小靜脈閉合、消失膠原纖維、纖維細(xì)胞纖維結(jié)締組織瘢痕組織（scartissue)吸收、消散Gran
2、ulationtissueScartissue五、瘢痕組織對機(jī)體的影響利1.保持組織器官完整性2.保持組織器官堅(jiān)固性弊1.瘢痕收縮2.瘢痕粘連3.瘢痕疙瘩(keloid)4.瘢痕膨出六、肉芽組織和瘢痕 組織的形成過程及機(jī)制血管生成成纖維細(xì)胞增殖和遷移細(xì)胞外基質(zhì)成分的積聚和成纖維組織的重建（一）血管生成的過程從發(fā)生學(xué)和組織學(xué)的觀點(diǎn)出發(fā)，把廣義的血管新生（neovascularization）分為兩種類型:endothelialprogenitorcell,EPCangioblast最近研究證明，血液中存
3、在EPC，它參與重癥缺血區(qū)域血管的形成，所以病理狀態(tài)下的血管生成，既包括廣義的血管形成，又有狹義的血管生成。血管形成（vasculogenesis）血管生成（angiogenesis）出芽方式的血管生成及包含的步驟：Vasodilation------NOIncreasedpermeability------VEGF?Proliferationofendothelialcellsjustbehindtheleadingfrontofmigratingcells?Remodelingintocapill
4、arytubes?Migrationofendothelialcellstowardtheareaoftissueinjury?Suppressionofendothelialproliferationandmigrationanddepositionofthebasementmembrane?Recruitmentofperiendothelialcells(pericytesforsmallcapillariesandsmoothmusclecellsforlargervessels)toform
5、thematurevesselTheprocessofangiogenesisinvolvesavarietyofgrowth factors,cell–cellinteractions,interactionswithECMproteins,andtissueenzymes.1、GrowthFactorsInvolvedinAngiogenesisVEGFBasicFibroblastGrowthFactor(bFGF)AngiopoietinsVEGFstimulatesbothmigration
6、andproliferationofendothelialcells,initiatestheprocessofcapillarysproutinginangiogenesis.VEGFcontributestotheformationofthevascularlumen.bFGF-2participatesinangiogenesismostlybystimulatingtheproliferationofendothelialcells.Italsopromotesthemigrationofma
7、crophagesandfibroblaststothedamagedarea,andstimulatesepithelialcellmigrationtocoverepidermalwounds.Ang1andAng2aregrowthfactorsthatplayaroleinangiogenesisandthestructuralmaturationofnewvessels.Matrixmetalloproteinases(MMPs)degradetheECMtopermitremodeling
8、andextensionofthevasculartube.2、ECMproteinsParticipatingintheprocessofvesselsproutinginangio-genesis.Providingthescaffoldforvesselgrowth.Integrins,especiallyαγβ3,haveimportantroleinformationandstabilityofvessel.ActivationofFibrob
