摘要
目的探讨过氧化物酶体增殖物激活受体γ（peroxisomeproliferator-activatedreceptor γ，PPAR-γ）激动剂吡格列酮药物延迟对大鼠跨区穿支皮瓣成活及choke血管的影响。方法取70只雄性SD大鼠，体重250～300g，随机分为实验组和对照组（n=35），在背部建立三血管体穿支皮瓣模型，包括两个choke血管区域。实验组术前按照10mg／（kg·d）剂量取吡格列酮并溶于1．5mL生理盐水，连续灌胃5d；对照组同时间点给予等量生理盐水灌胃。术后大体观察皮瓣成活状况，并于7d时测量皮瓣成活面积百分比。术后7d采用明胶．氧化铅灌注进行皮瓣血管造影观察，取皮瓣choke Ⅱ区中央区域组织行HE染色，测量微血管密度（microvesseldensity，MVD）；免疫组织化学染色观测VEGF表达情况。术后即刻及1、3、5、7d取choke Ⅰ区及Ⅱ区中央区域组织测量NO含量。结果术后两组皮瓣大体变化相似，随时间延长均有不同程度坏死，但7d时实验组皮瓣成活面积百分比（87．73％±3．25％）显著高于对照组（76．07％±2．92％）（t=10．338，P=-0．000）。血管造影显示实验组chokeⅠ、Ⅱ区真性吻合数分别达（5．40±1．14）、（3．00±0．71）个，均显著高于对照组的（3．20±0．84）、（0．80±0．84）个（F=3．479，P=-0．008；t=-4．491，P=0．002）。实验组chokeⅡ区MVD及VEGF表达分别为（33．16±7．73）个／mm2、4368．80±458．23，显著高于对照组的（23．29±5．91）个／mm2、2241．24±554．43（t=-5．073，P=0．000；t=14．789，P=0．000）。除术后即刻外，其余各时间点实验组chokeⅠ、Ⅱ区NO含量均显著高于对照组，差异均有统计学意义（P〈0．05）。结论PPAR-γ激动剂吡格列酮可通过促进皮瓣choke血管扩张及血管新生改善皮瓣血供，从而提高了大鼠背部跨区穿支皮瓣的成活率。
Objective To investigate tne effect of proliferator-activated receptor γ （PPAR-γ） agonist, on extended perforator flap survival in a rat model. Methods Seventy male Sprague Dawley rats, weighing 250-300 g, were randomly divided into control group （n=35） and experimental group （n=35）. A three-territory flap was made, including two choke zones. Pioglitazone was dissolved in 1.5 mL saline. Oral doses of pioglitazone [10 mg/（kg·d）] was given by gavaged for 5 days in the experimental group, while the same volume of saline was given in the control group at same time point. After γ days, the flap survival area was measured and angiographic diagnosis was made. The tissue samples were harvested from choke zone Ⅱ for histological study and vascular endothelial growth factor （VEGF） expression detection by immunohistochemical staining. The content of nitric oxide （NO） in choke zones I and II was measured at immediate, 1, 3, 5, and 7 days after operation. Results The flap general change of 2 groups was similar. Varying degrees of necrosis occurred with the extension of time in 2 groups. At 7 days after operation, the flap survival rate was 87.73%± 3.25% in the experimental group and 76.07% ± 2.92% in the control group, showing a significant difference （t=-10.338, P=0.000）. The number of true anastomosis in choke zonesⅠ and Ⅱwas 5.40 ± 1.14 and 3.00 ± 0.71 in the experimental group, and was 3.20 ± 0.84 and 0.80± 0.84 in the control group respectively, showing significant differences between the 2 groups （t= -3.479, P=0.008; t= -4.491, P=0.002）. The microvessel density and the expression of VEGF in choke zone II of experimental group were （33.16 ±7.73）/mmz and 4 368.80 ± 458.23, respectively, which were significantly higher than those of control group [（23.29 ± 5.91）/mm2 and 2 241.24 ± 554.43] （t=5.073, P=0.000; t= 14.789, P=0.000）. The content of NO in the experimental group were significantly higher than those in the control group at other time points （P
出处
《中国修复重建外科杂志》
CAS
CSCD
北大核心
2014年第6期701-706,共6页
Chinese Journal of Reparative and Reconstructive Surgery
基金
国家自然科学基金资助项目(81171695)~~
