中华整形外科杂志
中華整形外科雜誌
중화정형외과잡지
CHINESE JOURNAL OF PLASTIC SURGERY
2011年
1期
35-39
,共5页
林丁盛%郑鑫%李志杰%张义鹏%王安远%解学关%高伟阳
林丁盛%鄭鑫%李誌傑%張義鵬%王安遠%解學關%高偉暘
림정성%정흠%리지걸%장의붕%왕안원%해학관%고위양
水蛭素%随意型皮瓣%大鼠
水蛭素%隨意型皮瓣%大鼠
수질소%수의형피판%대서
Hirudin%Random pattern skin flap%Rats
目的 研究水蛭素对大鼠背部超长随意型皮瓣存活的影响.方法 采用改良大鼠"McFarlane flap"模型,将实验动物随机分为水蛭素实验组(水蛭素组)和生理盐水对照组(生理盐水组),水蛭素组局部注射3 ml(30 ATU)水蛭素,生理盐水组则注射3 ml生理盐水,连续注射7 d后分别检测两组皮瓣的存活面积百分比,并取皮瓣近、中、远段(即Ⅰ、Ⅱ、Ⅲ区)组织做光镜观察,免疫组化法检测血管内皮生长因子(VEGF)和碱性成纤维细胞因子(bFGF)的表达.结果 术后7 d,水蛭素组皮瓣的存活面积百分比为(69.52±3.23)%,生理盐水组为(50.36±2.37)%,水蛭素组显著高于生理盐水组,差异有统计学意义(P＜0.01);水蛭素组皮瓣坏死与存活并存的Ⅱ区,组织水肿、炎性细胞浸润情况明显比生理盐水组轻.水蛭素和生理盐水组皮瓣Ⅱ区的新生血管计数分别为(28.24±4.23)个/mm2和(17.45±5.43)个/mm2,两组比较差异有统计学意义(P＜0.05).通过计算累积吸光度A值(IA),得到水蛭素和生理盐水组VEGF阳性量分别为9262.23±896.99和4938.05±1623.67,bFGF阳性量分别为5122.83±1176.12和2779.45±472.00,水蛭组VEGF及bFGF的表达均高于生理盐水组,差异均有统计学意义(P＜0.01).结论 水蛭素可能通过体内一系列复杂的调控通路,最终增加VEGF、bFGF表达,促进皮瓣新生血管增生,改善皮瓣血供,减轻炎性反应,降低缺血皮瓣的坏死率,从而提高大鼠随意型皮瓣的存活.
目的 研究水蛭素對大鼠揹部超長隨意型皮瓣存活的影響.方法 採用改良大鼠"McFarlane flap"模型,將實驗動物隨機分為水蛭素實驗組(水蛭素組)和生理鹽水對照組(生理鹽水組),水蛭素組跼部註射3 ml(30 ATU)水蛭素,生理鹽水組則註射3 ml生理鹽水,連續註射7 d後分彆檢測兩組皮瓣的存活麵積百分比,併取皮瓣近、中、遠段(即Ⅰ、Ⅱ、Ⅲ區)組織做光鏡觀察,免疫組化法檢測血管內皮生長因子(VEGF)和堿性成纖維細胞因子(bFGF)的錶達.結果 術後7 d,水蛭素組皮瓣的存活麵積百分比為(69.52±3.23)%,生理鹽水組為(50.36±2.37)%,水蛭素組顯著高于生理鹽水組,差異有統計學意義(P＜0.01);水蛭素組皮瓣壞死與存活併存的Ⅱ區,組織水腫、炎性細胞浸潤情況明顯比生理鹽水組輕.水蛭素和生理鹽水組皮瓣Ⅱ區的新生血管計數分彆為(28.24±4.23)箇/mm2和(17.45±5.43)箇/mm2,兩組比較差異有統計學意義(P＜0.05).通過計算纍積吸光度A值(IA),得到水蛭素和生理鹽水組VEGF暘性量分彆為9262.23±896.99和4938.05±1623.67,bFGF暘性量分彆為5122.83±1176.12和2779.45±472.00,水蛭組VEGF及bFGF的錶達均高于生理鹽水組,差異均有統計學意義(P＜0.01).結論 水蛭素可能通過體內一繫列複雜的調控通路,最終增加VEGF、bFGF錶達,促進皮瓣新生血管增生,改善皮瓣血供,減輕炎性反應,降低缺血皮瓣的壞死率,從而提高大鼠隨意型皮瓣的存活.
목적 연구수질소대대서배부초장수의형피판존활적영향.방법 채용개량대서"McFarlane flap"모형,장실험동물수궤분위수질소실험조(수질소조)화생리염수대조조(생리염수조),수질소조국부주사3 ml(30 ATU)수질소,생리염수조칙주사3 ml생리염수,련속주사7 d후분별검측량조피판적존활면적백분비,병취피판근、중、원단(즉Ⅰ、Ⅱ、Ⅲ구)조직주광경관찰,면역조화법검측혈관내피생장인자(VEGF)화감성성섬유세포인자(bFGF)적표체.결과 술후7 d,수질소조피판적존활면적백분비위(69.52±3.23)%,생리염수조위(50.36±2.37)%,수질소조현저고우생리염수조,차이유통계학의의(P＜0.01);수질소조피판배사여존활병존적Ⅱ구,조직수종、염성세포침윤정황명현비생리염수조경.수질소화생리염수조피판Ⅱ구적신생혈관계수분별위(28.24±4.23)개/mm2화(17.45±5.43)개/mm2,량조비교차이유통계학의의(P＜0.05).통과계산루적흡광도A치(IA),득도수질소화생리염수조VEGF양성량분별위9262.23±896.99화4938.05±1623.67,bFGF양성량분별위5122.83±1176.12화2779.45±472.00,수질조VEGF급bFGF적표체균고우생리염수조,차이균유통계학의의(P＜0.01).결론 수질소가능통과체내일계렬복잡적조공통로,최종증가VEGF、bFGF표체,촉진피판신생혈관증생,개선피판혈공,감경염성반응,강저결혈피판적배사솔,종이제고대서수의형피판적존활.
Objective To investigate the effect of Hirudin on random skin flap survival in rats.Methods 24 SD rats were randomly divided into control group and experimental group. The "McFarlane flap(3 cm ×9 cm)" rat models were established on the rat dorsum. 3 ml Hirudin (30 ATU) was injected into the flap in the experimental group, while 3 ml saline in the control group. The injection was performed for 7 days. The flap survival area in the two groups was measured. The tissue samples were taken from proximal( Ⅰ ), middle( Ⅱ ) and distal( Ⅲ ) portions of flaps for histologic study. The VEGF and bFGF expression was also detected with immunohistochemistry method. Results 7 days after operation, the flap survival rate was ( 69.52 + 3.23 )% in the experimental group, while ( 50.36 ± 2.37 )% in control group,showing a significant difference between the two groups ( P ＜ 0.01 ). In the middle portion, tissue edema and infiltration of neutrophils in experimental group was markedly slighter than that in control group. The VEGF and bFGF expression and neovascularization was enhanced markedly in experimental group.Conclusions Hirudin can increase the survival of random pattern skin flaps. It may increase the VEGF,bFGF expression through a series of complex regulatory pathway. Then flap neovascularization is promoted and the flap blood supply is increased.
