4 курс / Дерматовенерология / Dermatologia_i_venerologia_KGMU_g_Simferopol_2012_g
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HbIM MeTa60AH'feCKHaKTHBHbIM opraHOM, IIhOlll,a)J.b KOToporo B cpe.n;-
HeM 1,6- 1,8 M2, Macca npH6Mi3HTeAbHO 16-20 % OT MaCCbI TeAa. Ko-
JKa COCTOHT H3 3IlH,n:epMHCa, .n;epMb I, rHno.n;epMbI. K rrpH,n:aTKaM KO:>KH OTHOC.HTC.H B OhOCbl, HOITH, CaAbHbJe H IIOTOBbie )Kehe3bI.
3nu.n.epMHC - HapJ)KHblH CAOH KOJKH - rrpe.n,cTaBAeH He-
npepbIBHO o6HOBASIIOI11,1IMHCSI 3 ITHTehHaAbHbIMH KheTKaMH 3IlHTehH0-
11.HTaMH (Ke paTHHOlJ.HTaMH), KOTOpbie IlOCTO.IIHHO HaxO.n,fiTC.H B npo -
u;ecce ,n:HcpcpepeHI.J.HpoBKH, Ha'IHHa.Hc HH)Kllero, c11.a60 ,n;RcpcpepemJ,H - poBannoro, 6a3aAbHoro c11.051 no Hanpas11.enmo K BepxHeMJ poroBOMJ ChOIO. 3nH,n:epMHC COCTOHT H3 HeCKOAbKHX TH!lOB KheTOK, HMeI-Olll,HX pa3h!-f"-IHOe 3M6pHOHaAbHOe npOHCXOJK,n:eHHe: 3IlHTehHOlJ.HTOB, MehaHOll,HTOB, BHJTPH3UH)l.epMaAbHbIX MaKpocparoB (KheTOK J\aHrepra.Hca), K/\eTOK MepKeASI; H pa3.n,e11.eH na Mmb Cll.oee: 6a3aAbHhIH, wHnOBH,u.- HbIH, 3epHHCTbIH, 611.eCTSIIll.HH H porOBOH, KOTOpbie OTpaJKaI-OT pa3HbJe CTa)l.HH ,n:HcpcpepeHlJ.HPOBKH 3fIHTeMiaAbHblX 31\.eMeHTOB.
I1o,n:.n:epJKaHHe KJ'.teTO'IHOrOroMeocTa3a B 3IlH,n:epMHCe B u;ehOM 3aBHCHT OT COOTHOilleHJUI o6pa3y!OUJ.HXC51 H non16a10w;Hx K/\eTOK. Ha 3TOT npou;ecc BAili.!e'l'MHO)KeCTBO cpaKTopos: ypoBeHb B3aHMO)J.e:i:i:CTBH51 3 ITHTehHOll,HTOB c .n:pyrHMH KheTKaMH 3 ITHJJ.epMHCa; Ka'IeCTBOa.n:- re3HH 3ITHTeAHOlJ.HTOB JI.pyr c .n:pyroM H 6a3aAbHOH MeM6paHoii; pa3-
hH"-IHbie 3a6011.eBa.HHSI KQ)KM, DO pa TH ITOA '!ehOBeKa,KhHMaTH'IeCKHe YChOBH51. 3nH,n: PMHC He HM eT CTporo onpe.n:e11.eHHOH TOhlll,HHbI H
BapbHpye-r |
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pa3HbIX y'!aCTKaxTe11.a: B 0611.aCTH ha)J.OHeii - |
OKOAO |
0,1 MM, H |
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JJ.OWBax - OT 0,8 JJ.O 1,4 MM, Ha .n:pyrHX yqacrKax TeAa |
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MeHee 1 MM. |
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Ba |
WtbHbtu cn.ou (stratum bazale). 3rr11TeAHOlJ.HTb1, pacrro- |
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11.mKeH.HbJ |
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aAbHOH MeM6paHe, SIBASIIOTCR 3apo)J.b1wesb1MH KAeT- |
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KaMH. KpoM |
' B 6a3aAbHOM CAOe IIpHCYTCTBYI-OT MeAaHOll,HTbl M |
8
KJ\e TKH MepKeMI. Ba3MbHbie KAeTKH pacrroAararoTC5I Ha 6a3MhHOH MeM6paHe H HMeIOT U:HAHH,D,pH'IeCI<ylO cpopM)'. Hx 5!Apa OBMhHOH
cpopMbI, HHTeHCHBHO OKpaII1HBaIOTC5I reMaTOKCHAHHOM H 6oraTbI
xpo MaTHHOM. B U:HTOI1Aa3Me 6a3MbHbIX KAeTOK HaxO)'.I.HTC5IMHOrO'lHCAeHHbre opraHelV\.bI: MHTOXOHAPHH, KOMilAeKC I'OAb,ll.}KH, pH60COMbI, IlOAHpH60COMhI, AH30COMbI, u:eHTpHOAH, 3HAOI1Aa3MaTH'leCK8.5! ceTb, TOHOcpHAaMeHTbI, o6pa3yror.qHe IJ;HTOCKeAeT, H pa3AH'IHI>IeBKAIO'lCHllil
(rpaHYAbI MeAaHI·rna, KarrAH :lKHpa) . HMtt<IHe 60Abll!OrO KOAH'leCTBa
ptt60COM o6yCAOBAeHO rrpoAHcpe pau.ueii 6a3aAbHbIX KJ\eTOK H CHHTe -
30M TOHOcpHAaMeHTOB.
Coe ,n,HHeHHe 6a3MbHbIX KAeToK Me:>KJJY co6oli ocym:ecTBMieTc5I noc pe,D,CTBOM ,n,eCMOCOM, pacrroAaraIOW:HXC5I B MeCTax KOHTaK.TOB AB)'X c oce,n,i-rnx KJ\eTOK '-repe3 orrpe,n,eAeHHbre H HTepBahhI. 3Ta CB5!3h
HrpaeT 6oAbIIIYIO pOAb B CTPYKTYPHOH u;eAOCTHOCTH 3IlH,D,epMHca H
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76 % COCT05IT |
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pa30M, |
XOAeCTepHH H cpoccpOAHITH,l(bI. BbICOKall MHTOTH'leCKaH aK- |
THBH OCTb pOCTKOBbIX KJ\eTOK HHOr,n,a ,n,eAaeT HX MHIIIeHh!O J]/\5f. pa3AH'lHbIX He:>Kei\.aTei\.bHblX B03,D,CHCTBHH, HarrpHMep Y<l>-H3AY'JeHH5!, H MO:lKCT npHBeCTH K o6pa3oBaHHIO onyxo11.eH: Ha KO:>Ke.
IIIunoeuoHbLU C.!lou (stratum spinosum) cocTOHT H3 3-8 p5I,D,OB KJ\eTOK, KOTOpbie 6011.ee ,n:ucpcpepeHI.l,MpOBaHbl, qeM 6a3aAbHbie KAeTKH. Henocpe,n:CTBeHHO HM 6a3MhHbIM CAOeM OHH HMe10T IlO/\.H- roHaAbHYIO cpopMy, a B BCpXHCH qacTli IllHilOBH,n:Horo Ci\.05I CTaHOB5ITC5I yn11.om:eHHblMH. 10..eT KH IllHI10BH,Ll,HOro Ci\.05[, KaK H 6a3aAbHhIC, KOHTaKTHPYIOT ,n,pyr c ,n:pyroM n ocpe,n,CTBOM ,Ll,CCMOCOM, KOAH'ICCTBO KOTOpbIX 3,l(CCb 6011.bUie, 'ITOnpH,n,aeT eMy 60AbllIYIO npO'IHOCTh. y i\.bTpacTpyK1}'PHOUIHllOBH,Ll,Hbie Ki\.eTKH IlOXO:>KH Ha 6a3aAhHbie, HO OT/\.H- 'laIOTC.Sl OT HHX 6011.ee pa3BHTOH CHCTeMOH TOHOcpHAaMeHTOB, MeHbUlHM co,n,ep:>Ka HHeM opraHei\.i\. H OTCYTCTBHCM rmrMeHTa. B BepXHeli qacTH llIJUIOBH,l(HOro Ci\.05I IlO.HBMIIOTC.Sl IlAaCTHH"laTbre rpaeyAbI (11.a- Mei\.i\.5IpHbie rpaHyAhI, Tei\.bIJ;a 0AAaH,D,a, KepaTHHOCOMbI), pacno11.a- rarom:HeC5I Ha nepHcpepHH KAeTOK, HHOr,n,a c oe,D,HHSIJOW:HCC5I c I1Aa3MaTH'{eCKOH MeM6paHOH AH6o BbJXO)'.I.Hlll,He B MCJKKAeTO'lHbi npoCTpaHCTBa. 3TH opraHe/1./1.bl co,n,ep:lKaT AHilH,Ll,bI, cpoccpoll.MilH,Ll,bI, CB060,n,Hbie cTepoAhr , u:epaMH,D,bI H rAHK03HAU:epaMHAhI. KpoMe Toro, B nAaCTHH'laTbJXrpaHy11.ax o6HapY:iKHBaeTC5I 6011.bUIOe KO/\.H'leCTBOrH,n,- pOAHTH"'lCCKHX cpepMCHTOB, TaKHX KaK KHC/\.aH cpoccpaTa3a, HYKJ\e0- 3 11,Ll,,Ll,HcpoccpaTa3a, cpoccpo11.11rra3br. CBoe co,n:ep:>KHMOe rpaHyAhr Bbr,n,e-
9
Ml:IOT B Me:>KKJ\eTO'!HOe rrpocTpaHCTBO, cpopMHPY.SI 3ITH,AepMaAhHbIH /\.HITH,ll,HblH 6apbep . B llIHITOBH.l(HOM . C/\.Oe HaxO.l(.SITC.Sl BttyTpH3ITH.n,epMaAhHbie MaKpocparH - KAeTKH AaHrepraHca.
3epnucmbLU c.nou (stratum granulosurn) npe,o,cras11.eH HeCKOAbKHMH p.Sip;aMH ynAOW:eHHblX 3IlHTe/\.HOU,HTOB. Kil.eTKH 3epHHCTOro CAO.SI TaIOKe COC)J.HH.SIIOTC.Sl .n.ecMOCOMaMH, Yil.bTp acrpyKTYPa KOTO - pbIX aHMOrH'!Ha TaKOBOH HH)KeJl.e)!<aru:Hx c11.oes, HO Ha rpaHHll,e c poroBbIM C/\.OeM OHH Tep.SilOT Me)KKJl.eTO'!HbIHKOHTaKTHbIH C/\.OH. 3ep - HHCTbie K/\.eTKH onpe,o,eMl:IOTCSI no xapaKTep HbIM LJ.HTOII/\.a3MaTI1'!e- CKHM 6a30cp.11AbHbIM KepaTOrHaAHHOBbIM rpaey11.aM. fpaey/\.bI KepaTOrHaAHHa TeCHO CB.H3aHbI c nyqKaMH TOI-IOcpm'l.aMeHTOB H COCT051T B OCHOBHOM H3 6e11.Ka npocpHAarrpHHa.
EJtec111.SlU,!UU c.nou (stratum lucidum) xoporno onpe.n.eAfleT- c.SI TO/\.hKO Ha 11.a.l(OH.SIX H IlO.l(OUIBax H COCTOHT H3 Il/\.OTHO pacno11.o- )KeHHbIX Y.n.AHHeHHbIX H ynAOIJ.J,eHHbIX KJ1.eToK, 11.mneHHhIX 51,0,ep . B
3TOM C/\.Oe 3IlH.Teil.HOlJ.HTbI npo.n.o~IOT CHHTe3HpOBaTb ~ MO.l(HcpHI.J,11poBaTb 6eAKH H cpepMeHTbI, yqacrsy10w:He He T O/\.hKO B KepaTHHH3a- U.HH, HO H B 3anporpaMM11.posaHHOM pa3pyrneHHH KJ1.eToK. B pe3yAhTaTe rrpo11:cxo.n.HT pa3pyrneHHe 6011.bWHHCTBa CTPYKTYP 3epHHCTbIX KAeTOK, BKJ\lO'la.SlHX 51,ll,pa. TaKa.Sl cpopMa .n.ec:TpYKll,HH MOpcpo11.oraqeCKH H 6HOXHMH'leCKHCOOTBCTCTBYeT anonT03HOH cpopMe rH6e11.H KAeTOK.
Pozoeou c.nou (stratum cormeum). IIoc11.e,o,HHH 3Tan )KH3He-
.n.esITe/\.bHOCTH 3IlHTeAHOLJ.HTOB npoxo;:i:HT B porosoM c11.oe, r.n.e OHH npespaw:a1-0TCH s no11.aroHa.AhHbre oporoseswHe KAeTKH, He co;:i:ep- )!(aI.U,He 51,Aep. TaKHe 3IlHTeAHOLJ.HTbI noAyqH11.H Ha3BaHHe •porosht e '!elIIyHKH•. PoroBOH C/\.OH 3aw:ionu,aeT KO~ OT noTepH BO)l.bl H npoHHKHOBeHHSI sew:ecTB H3BHe, a TaIOKe OT MexaHH'!eCKHXB03J1:CHCTBHH. 3TOT CAOH npe.n.cras11.eH pS!,AaMH porOBbIX qewyeK H 6011.ee BhI- p~eH s 0611.acTH 11.a,o,oHeli H no.n.orns, Ha ;:i:pyrHX yqacTKax Te11.a OH 3Ha'!HTe/\.bHOTOHblllC . TOAW:HHa porosoro C/\.OJl Tal{)!{e 3aBHCHT OT no11.a, B03pacra H HaAH'!HJl3a6011.eBaHHH KO)KH . ,ll,pyr OT ;:i:pyra '-IelllyHKH OT.l(e/\.eHbl Me)!(KJl.eTO'!HbIMHnpoMe~KaMH, B KOTOpbIX BHJ:I:Hbl MOCOMhI, HMelOW:He BH.11: YilAOTHeHHbIX o6pa3oBaHHH.
TaKHM o6pa3oM, 3nH;:i:epMHC .SIBMl:eTcJI e,n:HHOH cpyHKU.HOHaAhHOH H aHaTOMH'L!ecKoliCTPYKTYPOH KO:;>KH. Yc11.oBHoe pa3.n.e11.eHHe 3nHp;epMHCa Ha uecKOJ\.hKO c11.oes oTp~aeT, npe)!{)l;e scero, rrpou,ecc ,ll;HcpcpepeHQHpOBKH 3IlHTeAHOlJ.HTOB, KOTOpb!H rrpoTeJ<aeT B HeCKOll.b- KO 3Tanos: MaAOJ:I:HcpcpepeHQHpOBaHHbie K/\.eTKH B 6a3aAbHOM CJ\.Oe p;eJ\.JlTCSI HenpepbIBHO, npH 3TOM '!aCTb 3THX KJ\CTOK OCTaeTC.Sl Ha Mee-
10 |
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