术前注射重组人生长激素对狭长窄蒂皮瓣成活及血管生成的影响  

Effects of recombination human growth hormone before operation on flap survival and angiogenesis

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

机构地区：[1]苏州大学附属第二医院整形外科,215004

出　　处：《中华医学美学美容杂志》2015年第3期173-176,共4页Chinese Journal of Medical Aesthetics and Cosmetology

基　　金：苏州市科技发展计划指导项目（SWSD2012091）;苏州大学附属第二医院青年职工预研项目（SDFEYQN1308）

摘　　要：目的 观察狭长窄蒂皮瓣术前局部皮下连续注射重组人生长激素（rhGH）,对皮瓣成活及皮瓣组织血管生成的影响.方法 将40只SD大鼠按随机数字表法分为Ⅰ、Ⅱ两组,各20只.Ⅰ组于大鼠背部左侧拟皮瓣区局部皮下连续注射rhGH[0.4 IU/（kg·d）]3 d后,同Ⅱ组一起在左侧拟皮瓣区制作一个狭长窄蒂皮瓣模型,Ⅱ组为手术当天皮瓣区注射rhGH的对照组.两组术后连续皮瓣注射rhGH[0.4 IU/（kg·d）]7 d.术后第7天计算皮瓣成活面积.采集各时点两组皮瓣远端组织标本,用免疫组织化学和酶联免疫吸附试验（ELISA）检测血管内皮生长因子（VEGF）、CD34的表达,并计算皮瓣微血管密度.结果 术后第7天,Ⅰ、Ⅱ组皮瓣成活面积百分率分别为（100.00±0.00）％、（94.00±1.10）％,差异有统计学意义（P＜0.05）;相同时点比较,Ⅰ组皮瓣VEGF、CD34的表达及微血管密度值均高于Ⅱ组（P＜0.05）,手术当天差异最明显.结论 术前开始皮瓣局部连续注射rhGH可促进VEGF、CD34的表达及微血管生成,减轻皮瓣缺血、缺氧损伤,进而促进狭长窄蒂皮瓣的成活.Objective To observe the effect of recombinant human growth hormone on flap survival and angiogenesis through preoperative local subcutaneous continuous injection of rhGH in narrow pedicle flap.Methods 40 rats were divided into two groups at random,named as groups Ⅰ and Ⅱ,20 rats each.A narrow pedicle flap was designed on the left back of rat in groups Ⅰ and Ⅱ.Then group Ⅰ was subcutaneously injected with rhGH [0.4 IU/（kg · d）] for 3 days.Another group did not have any injection.After 3 days,we established a model of narrow pedicle flaps in the left back of animals.After operation,the flaps of groups Ⅰ and Ⅱ were injected with rhGH [0.4 IU/（kg · d）]for 7 days.The survival percentage of the flap was calculated at 7＇th day.Specimens were collected at the diffent point of time.Expression of VEGF,CD34 was detected by immunohistochemistry and ELISA.The MVD of the flaps was also calculated.Results According to the 7 days＇ observation after the surgery,the percentage of flap survival area for groups Ⅰ and Ⅱ was （100.00±0.00）％,and （94.00±1.10）％ （P＜0.05）.The expression of VEGF,CD34 and the MVD values of group Ⅰ was higher than that of group Ⅱ at the same point of time （P＜0.05）,especially on the day of surgery.Conclusions Preoperative and local subcutaneaous continuous injection of rhGH on flaps can enhance the expression of VEGF and CD34 and microvascular formation,mitigate the damage of ischemia and hypoxia to flap during the postoperative period,and therefore improve the survival of narrow pedicle flap.

关 键 词：皮瓣 重组人生长激素 血管生成 

分 类 号：R622.1[医药卫生—整形外科]