重组水蛭素对大鼠皮肤撕脱伤中CD11b/CD18及ICAM-1动态表达影响的研究  

Effect of recombinant hirudin on dynamic expression of CD11b/CD18 and ICAM-1 in rats with skin avulsion

作　　者：江波 廖毅 

机构地区：[1]西南医科大学附属医院整形烧伤外科,四川泸州646000

出　　处：《西南医科大学学报》2017年第2期128-131,共4页Journal of Southwest Medical University

摘　　要：目的:通过局部运用重组水蛭素对大鼠皮肤撕脱伤中黏附因子CD11b/CD18及ICAM-1动态表达的研究,探讨重组水蛭素对皮肤撕脱的保护与该三项指标之间是否有密切关系,以及对撕脱皮瓣成活率的影响变化及作用机理。方法:设计为蒂在侧腹部的任意皮瓣,并给予牵拉证实为撕脱皮瓣后进行实验,实验组注射水蛭素40 IU(1 m L),对照组注射等量生理盐水,正常观察组不做任何处理,直接抽取外周血液及切取皮肤进行检测;实验组及对照组分别于6个时间点抽取外周血,运用流式细胞仪检测CD11b/CD18在中性粒细胞的阳性表达率,切取皮瓣远端组织运用免疫组织化学染色检测血管内皮细胞膜表面ICAM-1的表达并定量分析,综合了解三者的动态变化,留取的大鼠观察皮瓣愈合情况并计算撕脱皮瓣成活率。结果:术后两组皮瓣均出现充血水肿现象,虽然随着时间的推移实验组及对照组CD11b/CD18阳性表达都在上升,但是,局部运用水蛭素后黏附因子阳性表达率明显低于对照组(P<0.05);对照组ICAM-1阳性表达率明显高于实验组(P<0.01);经观察发现实验组皮瓣的愈合成功率较空白对照组有明显的提升。结论:局部运用重组水蛭素对大鼠皮肤撕脱伤具有有效减低血液中黏附因子CD11b/CD18及组织中ICAM-1的作用,减少组织炎症反应,改善缺血再灌注过程中对血管内皮细胞的损伤,从而显著提高皮肤撕脱伤后皮瓣的愈合率。Objective： To investigate the effect of locally applied recombinant hirudin on the dynamic expression of CD11b/CD18 and intercellular adhesion molecule-1 （ICAM-1） in rats with skin avulsion, and to explore the association between the protective effect of recombinant hirudin on avulsed flap and the three adhesion factors, as well as the impact of recombinant hirudin on the survival rate of avulsed flap and its mechanism of action. Methods：A pedicled abdominal flap on any side was designed, and traction was performed to confirm the avulsed flap. The rats in the experimental group were injected with hirudin 40 IU （1 mL）, and the rats in the control group were injected with an equal volume of normal saline; peripheral blood was drawn at 6 time points. In addition, peripheral blood and skin samples were collected from normal rats receiving no treatment. Flow cytometry was used to determine the positive rate of CD11b/CD18 in neutrophils. The distal flap was sampled to measure the expression of ICAM-1 on the vascular endothelial cell membrane by immunohistochemical staining. The flap healing was observed, and the survival rate of avulsed flap was calculated. Results：The experimental group and control group showed flap congestion and edema. Although the positive rate of CD11b/CD18 increased over time in the two groups, they were significantly lower in the experimental group, where hirudin was locally applied, than in the control group （P 〈0.05）. The control group had a significantly higher positive rate of ICAM-1 than the experimental group （P 〈0.01）. The experimental group had a significantly increased flap survival rate compared with the control group. Conclusion：For rats with skin avulsion, local application of recombinant can effectively decrease CD11b/CD18 in blood and ICAM-1 in tissue, alleviate tissue inflammation, and reduce vascular endothelial cell injury during ischemia and reperfusion, thus significantly increasing the survival rate of avulsed flap.

关 键 词：重组水蛭素 皮肤撕脱伤 CD11B/CD18 ICAM-1 

分 类 号：R733.4[医药卫生—肿瘤]