不同照射方式对放射复合伤大鼠伤口愈合的影响  

Effects of different radiation modes on wound healing of radiation combined wound in rats

作　　者：张庆林[1] 崔玉芳[1] 莘旭妮[1] 杜丽[1] 马琼[1] 孙嵘[1] 谢玲[1] 李超[1] 韩媛[1] 李江利 毛建平[1] 

机构地区：[1]军事医学科学院放射与辐射医学研究所,北京100850 [2]武警8690部队医院,江苏宜兴214206

出　　处：《感染．炎症．修复》2009年第1期11-14,F0002,共5页Infection Inflammation Repair

基　　金：国家科技重大专项课题项目;军队医药卫生"十一五"基金资助项目(06MA310)

摘　　要：目的:建立放射复合伤伤口愈合模型,观察不同照射方式对放射复合伤伤口愈合的影响。方法:清洁级Wistar大鼠90只,按体重随机分为单纯创伤(单伤组)、全身照射+创伤(照伤组)和创伤+伤口局部照射(伤照组)3组。照射采用60Coγ-源单次全身照射5Gy(照伤组)或单次伤口局部照射25Gy(伤照组)。血细胞计数仪观察外周血像的变化;麦格-姬姆萨(MGG)方法检测外周血淋巴细胞凋亡指数;图像分析仪测量伤口愈合面积;病理学观察各组大鼠伤口愈合的动态变化。结果:与单伤组比较,照射后两组体重明显下降,照射后3～28d差异均有显著性,而伤照组体重于照射后3～28d较单伤组和照伤组均明显降低;照射后不同时间两照射组伤口均较单伤组愈合延迟,伤照组于照后3、7、10和15d与单伤组比较差异有显著性,且照射后15和21d伤口面积明显大于照伤组。与单伤组比较,两照射组动物外周淋巴细胞凋亡指数在照射后3d即明显升高,两组均于照射后15d升至最高,分别约为单伤组的1.49和1.62倍(P<0.01);而WBC计数结果表明,照射后1～28d两个照射组WBC均显著低于单伤组(P<0.01)。病理学观察表明,照射后早期伤口出血坏死较为明显;中期伤口区肉芽组织生机不良,毛细血管较少;晚期伤口愈合较慢,伤照组较照伤组愈合延迟4d,较单伤组延迟1周左右。结论:全身照射和伤口局部照射均可使伤口愈合明显延迟,创伤后再局部照射伤口愈合延迟更为明显,约较单伤组延迟1周左右。Objective：To reproduce a rat model of wound healing in wound combined with irradiation for the observation of the influence of different radiation modes on wound healing. Methods： Ninty male Wistar rats were randomly divided into three groups according to body weight as follows： simple wound （SW group）, systemic radiation＋wound （RW group） and wound＋local radiation（WR group）. Single dose of 5 Gy whole body ^60Co γ-ray was delivered to RW group rats, and a dose of 25 Gy local irradiation to the rats in WR group. Change in periph- eral blood white blood cells （WBC） was analyzed with hemocytometer, and apoptosis index of peripheral blood lymphocyte was detected by May-Grounward-Giemsa （MGG） assay. The wound healing area was measured by image analysis and the pathological changes in wound area were observed with HE staining under light microscope. Results：Compared with SW group, body weight of the rats of all the other groups obviously dropped with significant differences on days 3 to 28 after irradiation, and the body weight of WR group showed an obvious decrease when compared with that of SW and RW groups. The wound healing process was remarkably delayed in RW and WR groups and showed statistically significant differences on days 3 to 15 post-radiation compared with SW group, and the wound area in WR group was markedly larger than those of RW group on days 15 and 21. The apoptotic cell numbers in RW and WR groups were much larger than those in SW group, and they began to increase on day 3 and reached the peak value on day 15 ,and they were 1.49- and 1.62-fold of that of SW group, respectively. The WBC count in RW and WR groups was distinctively lower than that in SW group on days 1 to 28. Pathological changes, including distinct bleeding and necrosis at the earlier stage and less vigorous granulation tissue growth and angiogenesis in wound region were apparent at the intermediate stage, and delayed wound healing at the advanced stage was observed in RW and WR groups. Wound healing pr

关 键 词：大鼠 照射 放射复合伤 创伤愈合 

分 类 号：R-332[医药卫生] R657.16