草酸铂腹腔化疗对大鼠结肠吻合口愈合影响及粒-巨噬细胞集落刺激因子的干预效应  

The influence of intraperitoneal oxaliplatin on the healing of colonic anastomoses in rats with interfered effect of GM-CSF

作　　者：刘勇[1] 杨阳[2] 刘辉[3] 李淼[4] 宋云骏 

机构地区：[1]保定市第一中心医院肿瘤内科,河北省071000 [2]河北大学中医学院 [3]北京协和医学院基础医学院 [4]保定市第一中心医院妇产科,河北省071000 [5]承德市肿瘤医院肿瘤外科

出　　处：《中华临床医师杂志（电子版）》2011年第20期5960-5963,共4页Chinese Journal of Clinicians(Electronic Edition)

摘　　要：目的探讨术后早期腹腔注射草酸铂对大鼠结肠吻合口愈合的影响及粒-巨噬细胞集落刺激因子(GM-CSF)的干预效应。方法 42只Wistar大鼠实施结肠吻合术,术后随机分为对照组(A组)、草酸铂组(B组)和草酸铂+GM-CSF组(C组),每组14只,其中C组结肠吻合完成后于吻合口两侧浆膜下层注射GM-CSF。术后24hA组腹腔注射生理盐水20ml/kg,B组和C组腹腔注射草酸铂25mg/kg。通过测定吻合口爆破压、羟脯氨酸含量及胶原纤维含量,评价其对结肠吻合口愈合的影响。结果术后第7天所有大鼠再次剖腹探查,三组均出现吻合口漏,分别为1例、3例和2例,组间比较差异无统计学意义;三组的爆破压值及羟脯氨酸含量分别为:(195.95±2.97)mmHg、(169.26±4.31)mmHg、(191.15±1.84)mmHg;(11.40±1.12)μg/mg、(9.86±0.40)μg/mg、(11.38±0.50)μg/mg;Ⅰ、Ⅲ型胶原纤维含量分别为:(1.58±0.10)p·μm2、(1.08±0.11)p·μm2、(1.43±0.08)p·μm2;(1.38±0.11)p·μm2、(1.06±0.10)p·μm2、(1.34±0.09)p·μm2。A组、C组与B组比较差异有统计学意义(P<0.05)。结论术后早期腹腔注射草酸铂明显延缓结肠吻合口的愈合,而局部注射GM-CSF可消除化疗药物对结肠吻合口愈合的影响。Objective To investigate the influence of oxaliplatin, injected intraperitoneally, on healing of colonic anastomoses with or without granulocyte macrophage-colony stimulating factor(GM-CSF) applying. Methods Forty-two rats performed colon anastomoses were randomized to one of three groups. 1:control, 2:L-OHP, 3:L-OHP+GM-CSF. Rats in the L-OHP and L-OHP+GM-CSF groups received L-OHP 25 mg/kg intraperitoneally on postoperative day 1.The rats of L-OHP+GM-CSF group were injected with 50 μg of GM-CSF in the periananstomotic area. The control group received no treatment. We measured bursting pressures(BP), hydroxyproline contents (HPC) and collagen contents (CC) evaluated the resected anastomoses on postoperative day 7. Results The leakage rate of the ananstomoses was not significantly different among groups.the mean bursting pressures in the 7-day-old anastomoses were(195.95±2.97)mm Hg,(169.26±4.31)mm Hg,(191.15±1.84)mm Hg in control, L-OHP and L-OHP+GM-CSF group respectively.The hydroxyproline contents in each group were(11.40±1.12)μg/mg,(9.86±0.40)μg/mg,(11.38±0.50)μg/mg respectively, samely, the type Ⅰ and Ⅲ collagen contents in each group were(1.58±0.10)p·μm2,(1.08±0.11)p·μm2,(1.43±0.08)p·μm2 ;(1.38±0.11)p·μm2,(1.06±0.10)p·μm2,(1.34±0.09)p·μm2 respectively. Both BP, HPC and CC in control group were significantly higher than that in L-OHP group(P<0.05). Both BP, HPC and CC in L-OHP+GM-CSF group were also significantly higher than that in L-OHP group(P<0.05). Conclusions GM-CSF administration counteracts the detrimental effects of intraperitoneal oxaliplatin treatment on colonic anastomoses in rats.

关 键 词：铂 药物疗法 注射 腹腔内 外科吻合口 伤口愈合 

分 类 号：R735.2[医药卫生—肿瘤]