摘要
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.
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.
出处
《中华整形外科杂志》
CAS
CSCD
北大核心
2011年第1期35-39,共5页
Chinese Journal of Plastic Surgery
基金
温州市科技计划项目（Y20090145）
关键词
水蛭素
随意型皮瓣
大鼠
Hirudin
Random pattern skin flap
Rats
