天然水蛭素对大鼠背部随意皮瓣早期断蒂后成活的影响  

EFFECT OF NATURAL HIRUDIN ON SURVIVAL OF DORSAL RANDOM FLAP AFTER EARLY PEDICLE DIVISION IN RATS

作　　者：韩志强[1] 殷国前[1] 韦淑怡[1] 林博杰[1] 潘新元[1] 

机构地区：[1]广西医科大学第一附属医院整形美容外科南宁,530021

出　　处：《中国修复重建外科杂志》2013年第6期738-742,共5页Chinese Journal of Reparative and Reconstructive Surgery

基　　金：广西壮族自治区卫生厅重点科研课题资助项目(2011101)~~

摘　　要：目的探讨天然水蛭素对大鼠背部随意皮瓣早期断蒂后成活的影响。方法取成年Wistar大鼠38只,雌雄不限,体重220～280 g;随机分成天然水蛭素组(实验组)和生理盐水组(对照组),每组19只。于两组大鼠背部制备大小为9 cm×3 cm的随意皮瓣后,A组在距蒂部2、4、8 cm处选择6个对称注射点,每点注射0.5 mL(3 ATU)天然水蛭素;对照组对应注射等量生理盐水;每天注射1次至实验完成,术后4 d断蒂。大体观察大鼠皮瓣成活情况,并于断蒂术后7 d测量皮瓣成活面积百分比。于皮瓣制备后即刻、断蒂术前1 d及断蒂术后3、7 d,取标本行组织学及免疫组织化学染色观察,测量微血管密度(microvessel density,MVD),荧光定量RT-PCR检测VEGF mRNA的表达。结果两组大鼠均存活至实验完成。断蒂术后实验组皮瓣坏死范围均小于对照组,7 d时实验组皮瓣成活面积百分比为85.366%±2.872%,显著高于对照组的75.252%±3.455%(t=7.117,P=0.000)。组织学观察示皮瓣制备后即刻两组毛细血管无显著差异,但断蒂术前1 d及断蒂术后3、7 d实验组毛细血管均明显多于对照组。免疫组织化学染色示,两组均有CD34阳性细胞表达;但断蒂术前1 d及断蒂术后3、7 d,实验组MVD均显著高于对照组,差异有统计学意义(P<0.05)。断蒂术后7 d,荧光定量RT-PCR检测示实验组VEGF mRNA表达量为7.122±0.503,对照组为5.655±1.174,两组比较差异有统计学意义(t=3.633,P=0.003)。结论天然水蛭素可以通过提高VEGF的表达,促进大鼠背部随意皮瓣血管生成,改善皮瓣血供,促进随意皮瓣早期断蒂并成活。Objective To explore the effects of natural hirudin on the survival of dorsal random flap after early pedicle division in rats.Methods Thirty-eight adult Wistar rats,male or female,weighing 220-280 g,were selected and randomly divided into natural hirudin group（experimental group,n=19） and normal saline group（control group,n=19）.The dorsal random flap of 9 cm × 3 cm in size was prepared on the back of the rats.Six symmetrical injection points were selected at 2,4,and 8 cm from the pedicle,0.5 mL（3 ATU） natural hirudin and equivalent normal saline were injected in experimental group and control group respectively every day to the end of the experiment.After 4 days,the pedicles were cut.The flap was observed,and the ratio of flap survival area was measured at 7 days after pedicle division.At immediately after flap preparation,at 1 day before pedicle division,and at 3 and 7 days after pedicle division,the specimens were harvested for histological staining,immunohistochemical staining,microvessel density（MVD） measurement,and detection of vascular endothelial growth factor（VEGF） mRNA expression by fluorescent quantitative RT-PCR.Results All rats of 2 groups survived to the completion of the experiment.After pedicle division,the flap necrosis area of experimental group was smaller than that of control group;at 7 days,the ratio of flap survival area in experimental group was 85.366% ± 2.872%,and was significantly higher than that in control group（75.252%？± 3.455%）（t=7.117,P=0.000）.Histological staining showed that no significant difference was found in the number of capillaries between 2 groups at immediately after flap preparation;at 1 day before pedicle division and at 3 and 7 days after pedicle division,the capillary number of experimental group was significantly more than that of control group.Immunohistochemical staining showed that CD34 positive cells were observed in 2 groups;MVD of experimental group was significantly higher than that of control group at 1 day before pedicle divi

关 键 词：天然水蛭素 随意皮瓣 早期断蒂 大鼠 

分 类 号：R622[医药卫生—整形外科]