乒乓球拍样任意皮瓣局部注射重组人生长激素促进其成活的实验研究  

Experimental study of the effect of recombination human growth hormone on the PingPang Racket flap survival

作　　者：孙卫[1] 赵天兰[1] 余道江[1] 伍丽君[1] 柴筠[1] 

机构地区：[1]苏州大学附属第二医院整形外科,江苏省苏州市215004

出　　处：《中华显微外科杂志》2014年第2期152-156,共5页Chinese Journal of Microsurgery

基　　金：苏州市科技发展计划指导项目（SWSD2012091）;苏州大学附二院青年职工预研项目（SDFEYQN1308）

摘　　要：目的探讨乒乓球拍样任意皮瓣局部皮下注射重组人生长激素（rhGF）对皮瓣成活的作用。方法于40只成年SD大鼠背部两侧各制作一个乒乓球拍样任意皮瓣，其蒂部为1cm×1cm，携带瓣部为3cm×3cm，皮瓣纵轴与背部中线垂直，蒂部近端距中线约1cm。左侧皮瓣为I组和右侧皮瓣为Ⅱ组，两组又分a、b组，每组各20只。I组于皮瓣表面均匀设计6个注射点，于注射点皮下注射rhGF0．1IU／Kg～·d～，从手术中起，连续注射7d。Ⅱ同法连续注射等量生理盐水7d。Ia组和IIa组每日对皮瓣进行大体观察，术后第7d计算皮瓣成活面积。Ib组和Ⅱb组于术中（注射rhGF之前）、术后1、3、5、7d取皮瓣远端全厚成活标本。用免疫组化法及ELASA法检测不同时间点皮瓣远端组织中TGF一13．、CD34的表达情况，并计算皮瓣微血管密度。结果①术后7d，Ia组和Ⅱa皮瓣成活面积百分比分别为（97．00＋2．12）％和（81．00＋3．43）％，Ia组的皮瓣成活面积明显大于Ⅱa组（P〈0．05）。②Ib组和IIb组免疫组化与ELASA法检测术后不同时间点TGF一13，、CD34表达均升高，术后5d达峰值，Ib组TGF—β1、CD34含量分别为（1571．40±13．32）pg／ml、（60．40±0．32）pg／ml，Ⅱb组TGF—β1、CD34含量分别为：（691．43±11．06）Pg／ml、（20．43±0．06）pg／ml，相同时间点两组比较，Ib组较Ⅱb组升高明显，差异有统计学意义（P〈0．05）。③Ib组和Ⅱb组术后l、3、5、7d皮瓣微血管密度值均增加，第3、5天增加明显，第7天趋于稳定，相同时间点两组比较，Ib组均高于Ⅱb组，两组差异有统计学意义（P〈0．05）。结论rhGF皮瓣局部注射可使皮瓣组织内TBG—1、CD34的表达增加，直接或间接地促进皮瓣组织微血管生成，具有较强的促进乒乓球拍样任意皮瓣成活的作用。Objective To investigate the effect of recombinant human growth hormone on the PingPang Racket flap survival. Methods Every two PingPang Racket flaps were designed on the both sides of 40 adult SD rats＇s back. The pedicle size was 1.0 cm x 1.0 cm, while the flap size was 3.0 cm in diameter circular. Longitudinal axis of flap was perpendicular to the center line of the rats back, to which the distance from proximal pedicle was about 1 cm. The flaps on the left side served as I group, and the other side served as ]] group, which were subdivided into Ia and Ib, ]]a and lrn, respectively. And there were 20 rats in each subgroup. On the flap surfaces in group I , it was 6 uniform injection poinsts, subcutaneously injecting with rhGF （the dose was 0. 11U ·Kg-l. d-1 ） for 7 days from the beginning of operation, that were designed. It goes the same way to the group U , while normal saline was instead of rhGF. In subgroup Ia and ]]a, the flaps were generally observed every day. The percentage of the flap survival area was determinated 7 days after operation. In subgroup lb and ]113, specimens were collected at the distal end of flap at intraoperative（before injecting rhGF）and 1 st, 3rd, 5th, 7th day after operation. Immunohistochemistry and enzyme-linked immunosorbent were applied to examine the expression of TGF-β1 and CD34, and the microvessel density of the flaps was calculated. Results According to the 7 days＇ observation after the surgery, the flap survival area percentage of subgroup ｜a was （ 97.00 ＋ 2. 12） % , which was significantly higher （ P 〈 0. 05 ） than that of subgroup ]] a, whose was （81.00 ＋3.43）%. On 1st, 3rd, 5th and 7th day postoperatively, the expression of TGF-131, CD34 in both subgroup Ib and lib were elevated and reached peak on the 5th day. Content of GF-131 and CD34 in Ib were 1571.40 ＋ 13.32 pg/ml and 60. 40 ±0. 32 pg/ml, respectively, and in lib were 691.43 ＋ 11.06 pg/ml and 20.43 ＋ O. 06 pg/ml. At the same point of time, the expression of TGF-131 , CD3

关 键 词：重组人生长激素 外科皮瓣 转化生长因子-β1 白细胞分化抗原34 微血管密度 

分 类 号：R622[医药卫生—整形外科]