重组人促红细胞生成素对糖尿病大鼠随意皮瓣的影响  

Recombinant Human Erythropoietin Improves Random Pattern Skin Flap Survival in Diabetic Rats

作　　者：何智灵[1] 李浙峰[1] 高伟阳[1] 李俊杰[1] 林康[1] 吕雷[1] 高自勉[1] 茹翱[1] 

机构地区：[1]温州医学院附属第二医院,325027

出　　处：《医学研究杂志》2013年第4期44-48,共5页Journal of Medical Research

基　　金：国家自然科学基金资助项目(81171695);温州市科技计划项目(Y20080082)

摘　　要：目的研究重组人促红细胞生成素对糖尿病大鼠超长随意皮瓣存活的影响。方法 36只SD大鼠。随机选取12只为对照组(A组),其余24只腹腔注射链脲佐菌素(STZ)建立糖尿病大鼠模型后随机平均分为两组(B组、C组),再次构建大鼠背部任意瓣(3cm×10cm)模型,成模后B组术后腹腔注射重组人促红细胞生成素(rhEPO)(5000 U/kg),A组、C组腹腔注射等量生理盐水。术后第10天取皮瓣检测成活面积、组织学观察、VEGF表达情况,ELISA检测血清中SDF-1α及MMP-9含量。结果皮瓣面积C组(33.34±2.01)%明显低于A(50.17±2.29)%组与B(48.3±2.43)%组(P<0.01),A、B组间比较无统计学差异(P>0.05);组织学观察B组皮瓣的组织水肿、炎症细胞浸润情况明显比C组减轻;新生血管计数B组17.5±3.29/平方毫米明显高于A组22.08±3.84/mm2,A、B组均明显高于C组11.33±2.42/mm2(P<0.01)。VEGF表达量A组4528.16±551.26、B组3671.67±482.04明显高于C组2571.08±535.45(P<0.01),A组与B组无差异(P>0.05)。血清中SDF-1α、MMP-9的含量A组、B组均明显高于C组(P<0.01)。结论促红细胞生成素可能通过增加SDF-1α、MMP-9、VEGF表达等途径促进皮瓣生血管增生,减轻炎症反应,从而提高糖尿病大鼠随意型皮瓣的存活。Objective To investigate the effect of recombinant human erythropoietin （rhEPO） on random skin flap survival in diabet- ic rats. Methods Of 36 SD rats, 12 rats were chosen as normal control group（group A）. Diabetes was induced by intraperitoneal injec- tion of streptozotoc in 24 SD rats, which were randomized into two groups （ B and C group） ,with 12 rats in each group. A dorsal caudally based random flap measuring 3cm × 10cm was created in all 36 SD rats and received the following treatment：group A and group C with sa- line injected through the intraperitoneal route after operation,and group B with a single - dose rhEPO 5000 IU/kg injected through the in- traperitoneal route after operation. The viability of the flap was measured at day 10 and the tissue samples from the border lines between the surviving and the necrotic areas were stained with hematoxylin and eosin （H＆E） reagent. Blood was harvested for serum. MMP- 9 and SDF - 1 α protein levels were assessed by ELISA. The VEGF expression was detected with immunohistochemistry method. Results On postoperative day 10, survival rate of the flaps in both group A （50.17±2.29）% and group B（48.3 ±2.43 ）% was significantly higher than in group C（33.34 ±2.01 ） % （ P 〈 0. 01 ） , and there was no significant difference between group A and group B. Tissue edema and infiltration of neutrophils in group B was markedly slighter than that in group C. New blood vessels increased in the group B （ P 〈 0. 01 ）. The expression of VEGF between group B and group C was significantly different 3671.67 ±482.04 vs 22571.08 ± 535.45 ,P 〈 0.01. The MMP- 9 and SDF- 1 α expression levels in both group A and B were significantly higher than those in group C（P 〈 0. 01 ）. Conclusion rhEPO can enhance the survival of random skin flap of diabetic rats. It may increase the MMP - 9, SDF - 1 （ and VEGF expression. Then flap neovascularization is enhanced and the flap blood supply is augmented.

关 键 词：重组人促红细胞生成素 随意型皮瓣 糖尿病大鼠 

分 类 号：R692.5[医药卫生—泌尿科学]