山莨菪碱对皮瓣缺血再灌注损伤保护机制的实验研究  

Experimental study on the protective effect of Anisodamine on flaps with ischemia reperfusioninjury

作　　者：卢强[1] 陈英标[1] 戴帆[1] 仇树林[1] 

机构地区：[1]河北省人民医院烧伤整形科,石家庄050081

出　　处：《中华整形外科杂志》2013年第3期202-205,共4页Chinese Journal of Plastic Surgery

摘　　要：目的观察山莨宕碱注射液对大鼠缺血再灌注皮瓣成活面积及组织学变化的影响，以期证实山莨宕碱具有防治皮瓣坏死、提高皮瓣成活率的疗效。方法48只大鼠随机分为缺血再灌注盐水组、缺血再灌注山莨宕碱处理组及对照组，建立以腹壁浅血管为蒂的轴型皮瓣，3组大鼠于掀起皮瓣后即刻及掀起皮瓣后12、18、34h分别于皮瓣中段取材，检测皮瓣组织中超氧化物歧化酶（SOD）、一氧化氮（NO）及核因子NF—κB的含量，显微镜下观察皮瓣组织病理学变化情况，并于术后第7天观测皮瓣成活率。结果缺血再灌注山莨宕碱处理组皮瓣成活率为（78．6％±7．3）％，再灌注后2、8、24h皮瓣组织中SOD含量为（103．3±3．9）、（82．6±3．8）、（67．5±4．6）U／mg，NO含量为（5．33±2．05）、（4．75±1．68）、（4．15±1．59）nmol／mg，NF—KB含量为0．211±0．039、0．313±1．033、0．096±1．028。3组大鼠皮瓣组织中SOD、NO及NF—κB的含量在不同时刻相比较差异均有统计学意义；山莨宕碱处理组大鼠皮瓣病理变化情况明显好于盐水组；山莨宕碱处理组皮瓣成活率明显高于盐水组。结论山莨宕碱能够减轻再灌注后皮瓣组织内自由基损伤，增加皮瓣术后血运，减少核因子NF-KB的产生，减轻炎性反应，增强皮瓣抗感染能力，从而可有效减轻皮瓣缺血再灌注损伤，降低皮瓣坏死率，提高皮瓣移植成活率。Objective To observe the effect of anisodamine（Ani） injection on the survival rate and histologic result of flaps with ischemia-reperfusion injury, so as to demonstrate the protective effect of Ani on the flap survival. Methods A total of 48 healthy male Wistar rats were randomly divided into model control, normal saline（NS） and anisodamine groups, with 16 rats in each group. An 3 cm × 6 cm axial flap was formed at the right lower abdomen with abdominal superficial blood vessel as the pedicle. O. 5 cm × 0. 5 cm skin tissue was taken from the middle part of flaps in each group, immediately after operation, 12, 18, 24 h after operation. The superoxide dismutase （SOD）, nitric oxide（NO）, nuclear factor-KB contents in the specimens were detected. The histologic study was also performed. The flap survival rate was recorded 7 days after operation. Results Flap survival rate was （ 78.6 ± 7. 3 ） % in Anisodamine group. 12,18,24 h after reperfusion injury, the SOD was （ 103.3 ± 3.9）, （82.6 ±3.8）, （67.5±4.6） U/mg;theNO was （5.33 ±2.05）,（4.75±1.68）,（4.15 ±1.59） nmol/mg;the NF-KB was0.211 ±0.039, 0.313 ±0.033,0.096 ±0.028. The contents of SOD, NO and NF-KB had the statistical difference of at different time. The skin pathological changes in Anisodamine group was obviously better than those in NS group. Flap survival rate in Anisodamine group was significantly higher than that inNS group. Conclusions In the flap with ischemia-reperfusion injury, Anisodamine can reduce the damage of free radical, increase the blood flow, reduce the production of NF-KB, decrease inflammatory reaction. So Anisodamine can increase the survival rate of flaps with ischemia reperfusion injury.

关 键 词：山莨宕碱 外科皮瓣 再灌注损伤 

分 类 号：R6[医药卫生—外科学] R28[医药卫生—临床医学]