氧自由基清除剂提高大鼠扩张皮瓣成活率的作用及血管保护机制  

The study of oxygen free radical scavenger in improving expanded flap＆#39;s viability and mechanism of protecting blood vessels in rats

作　　者：张栋益[1] 康深松[1] 张正文[1] 吴蕊[2] 

机构地区：[1]河南省人民医院(郑州大学人民医院)整形外科,郑州450003 [2]河南省人民医院(郑州大学人民医院)心肺功能科,郑州450003

出　　处：《中华实验外科杂志》2016年第5期1207-1209,共3页Chinese Journal of Experimental Surgery

基　　金：河南省重点科技攻关计划资助项目（132102310088）

摘　　要：目的 探讨氧自由基清除剂提高大鼠扩张皮瓣成活率的作用及血管保护机制.方法 48只成年SD大鼠随机分成对照组、维生素E治疗组、依达拉奉治疗组,每组16只.于各组大鼠背部均埋入30 ml软组织扩张器1个,术后定期注水扩张至32 ml.再次手术取出软组织扩张器,并于背部扩张区形成蒂部位于尾侧的2.0 cm ×6.0 cm的任意皮瓣.皮瓣形成后即刻开始,维生素E治疗组、依达拉奉治疗组、对照组大鼠分别经尾静脉注射维生素E注射液（100 mg/kg）、依达拉奉注射液（10 mg/kg）、生理盐水1ml;频率均为每12h注射1次,直至术后第3天.扩张皮瓣形成后24h各组分别随机选取8只大鼠对皮瓣进行取材,通过原位标记皮瓣中段、远端组织血管壁的凋亡细胞,计算2个区域皮瓣血管壁组成细胞的凋亡率.术后第7天计算各组大鼠皮瓣成活率,并以免疫组织化学染色标记皮瓣中段血管,计数皮瓣中段皮下平均血管数.结果 术后24h,皮瓣中段、远端的血管壁组成细胞凋亡比率在维生素E治疗组分别为（12.47±1.58）％、（23.35±2.46）％,在依达拉奉治疗组分别为（11.01 ±1.67）％、（18.94±1.35）％;结果均显著低于对照组的（15.82±2.25）％、（28.34±1.17）％（P＜0.05）;且依达拉奉治疗组皮瓣远端的血管壁组成细胞凋亡比率显著低于维生素E治疗组（P＜0.05）.术后7d,皮瓣成活率、皮瓣中段皮下平均血管数目在维生素E治疗组分别为：（64.17±2.82）％、（11.52±1.09）个/高倍视野,依达拉奉治疗组分别为（73.66±3.24）％、（13.63±1.78）个/高倍视野,结果均显著高于对照组的相应皮瓣成活率及皮下平均血管数目[（41.92±3.59）％、（4.30±0.86）个/高倍视野,P＜0.05];且依达拉奉治疗组皮瓣成活率、皮瓣皮下平均血管数目均显著高于维生素E治疗组（P＜0.05）.结论 依达拉奉较维生素E更能有效提高扩张皮瓣的成活率;作用机制与Objective To study the effect of oxygen free radical scavenger in improving expanded flap＆#39;s viability and mechanism of protecting blood vessels in rats.Methods Forty-eight adult SD rats were randomly divided into control group,vitamin E treated group and edaravone treated group,sixteen rats in each group.A soft tissue expander of 30 ml was put into back of every rat in all the three groups.After the operation,normal saline was injected into every soft tissue expanders regularly until the total volume reached to 32 ml.All the soft tissue expanders were removed in the other operation,and then formed a flap sized 2 cm × 6 cm in the expanded area of back with the pedicle located at the trailing side.After flaps were formed immediately,vitamin E injection （100 mg/kg）,edaravone injection （10 mg/kg） and 1 ml normal saline were respectively injected into rats in vitamin E treated group,edaravone treated group and control group via the tail veins;the frequency of injection was once every 12 hours and until 3 days after the operation.24 hours after the operation,samples of flaps were harvested from eight rats which selected randomly from each group,calculated the apoptotic ratio of cells in vascular wall which located in the middle and distal of the flaps through situ labeling.7 days after the operation,calculated the flap＆#39; s viability of each group,and marked blood vessels which located in the middle of the flaps by immunohistochemical staining for calculating the average number of vessels subcutaneous flaps.Results 24 hours after the operation,the apoptotic ratio of cells in vascular wall that located in middle and distal of the flaps were respectively （12.47 ± 1.58）%,（23.35 ±2.46）% in vitamin E treated group and （11.01 ± 1.67）%,（18.94 ± 1.35）% in edaravone treated group;all of the ratio were significantly lower than that in control group correspondingly with the ratio （15.82 ±2.25）%,（28.34 ±1.17）% （P〈0.05）;and in edaravone treated group,the apoptotic ratio of cell

关 键 词：依达拉奉 维生素E 扩张皮瓣 缺血再灌注损伤 血管 

分 类 号：R622[医药卫生—整形外科]