低剂量X线照射促进大鼠缺血皮瓣成活及与血管内皮生长因子和基质金属蛋白酶-9表达的关系  

Effect of low-dose irradiation on improving ischemic flap survival and its correlation with the expressions of vascular endothelial growth factor and matrix metalloproteinase-9 in rats

作　　者：张赛圣 程丽霞 杨志宏 ZHANG Sai-sheng;CHENG Li-xia;YANG Zhi-hong(Department of Burn Surgery,the Affiliated People＇s Hospital of Hubei University of Medicine,Shiyan 442000,China)

机构地区：[1]湖北医药学院附属人民医院烧伤整形外科,湖北十堰442000 [2]湖北医药学院附属东风医院血液内科,湖北十堰442000

出　　处：《中华实用诊断与治疗杂志》2018年第8期747-750,共4页Journal of Chinese Practical Diagnosis and Therapy

基　　金：湖北省教育厅科学研究计划指导性项目(B2015173)

摘　　要：目的探讨低剂量X线照射(low-dose irradiation,LDI)对行皮瓣形成术大鼠缺血皮瓣成活的影响,及其与血管内皮生长因子(vascular endothelial growth factor,VEGF)、基质金属蛋白酶-9(matrix metalloprotein-9,MMP-9)表达的关系。方法 SD大鼠96只随机分为观察组和对照组各48只,2组均行皮瓣形成术制备缺血随意皮瓣。观察组大鼠于皮瓣形成术后,应用总剂量为0.2Gy的LDI单次局部照射缺血皮瓣处,对照组不予LDI。术后4、7、10、14d,2组分别取12只大鼠观察缺血皮瓣成活情况,并计算皮瓣成活率;处死大鼠,取皮瓣组织行HE染色观察组织学变化,并计算新生微血管密度(new microvessel density,NMVD);采用ELISA法检测血清VEGF和MMP-9水平。结果术后14d,2组大鼠均无死亡,缺血皮瓣远端均坏死,但观察组皮瓣坏死区域较对照组小,HE染色示观察组炎症细胞浸润较对照组少,具有清晰的组织结构和较为丰富的皮下血管;术后4d,观察组缺血皮瓣成活率[(76.22±1.49)%]与对照组[(74.50±2.19)%]比较差异无统计学意义(P>0.05),术后7、10、14d,观察组皮瓣成活率[(84.70±10.50)%、(89.20±7.80)%、(94.80±8.90)%]高于对照组[(79.20±11.00)%、(82.50±8.90)%、(85.20±5.60)%](P<0.05);术后4、7、10、14d,观察组缺血皮瓣NMVD[(74.18±25.98)、(114.94±17.83)、(88.13±21.39)、(69.66±12.13)个/mm2]均高于对照组[(33.47±8.32)、(36.70±7.71)、(43.45±7.39)、(37.12±8.72)个/mm2](P<0.05);术后4d,观察组血清VEGF[(1 020.22±12.05)ng/L]、MMP-9[(14.80±2.23)μg/L]水平与对照组[(1 010.12±9.98)ng/L、(14.67±2.25)μg/L]比较差异均无统计学意义(P>0.05),术后7、10、14d,观察组血清VEGF[(1 782.09±10.33)、(1 720.88±28.11)、(1 749.32±10.02)ng/L]、MMP-9[(18.66±1.93)、(21.94±2.94)、(22.91±1.62)μg/L]水平均高于对照组[VEGF(1 379.87±11.10)、(1 230.93±17.22)、(1 440.29±9.21)ng/L,MMP-9(16.41±1.88)、(16.76±2.44)、(18.72±1.48)μg/L](P<0.05)。结论 LDI可促进大鼠缺血皮瓣成活,Objective To discuss the effect of low-dose irradiation （LDI） on isehemic flap survival and its correlation with the expressions of vascular endothelial growth factor （VEGF） and matrix metalloproteinase-9 （MMP-9） in rats. Methods Ninety-six healthy SD rats were randomly divided into observation group and control group, with 48 rats in each group. Asymmetrical ischemic flap was prepared after flap plasty. Observation group received single LDI of 0.2 Gy only on ischemic flap immediately after surgery, and control group was not treated. By day 4, 7, 10 and 14 after surgery, the survival of the ischemic flap was observed in 12 rats from each group, and the survival rate of the flap was calculated. The rats were sacrificed to observe the tissue changes by HE staining, and the new microvessel density （NMVD） was calculated. The serum VEGF and MMP-9 levels were detected by ELISA method by day 4, 7, 10 and 14 after surgery. Results All rats survived in 14 days after operation, with necrosis at the distal end of the ischemic flap. The necrosis area of the flap was smaller in observation group than that in control group. HE staining showed less infiltration of inflammatory cells in observation group, with a clear tissue structure and more abundant subcutaneous blood vessel. The survival rate of ischemic flap showed no significant difference between observation group （（76.22 ± 1.49）%） and control group （（74.50±2.19）% ） by day 4 after surgery （P〉0.05）. The survival rates of is chemic flap were significantly higher in observation group （（84. 70±10.50）%, （89. 20±7.80） %, （94. 80±8.90） %） than those in control group （（79. 20± 11.00）%, （82. 50±8. 90）%, （85. 20±5. 60）%） by day 7, 10 and 14 after surgery （P〈0.05）. The NMVDs of ischemic flap were significantly higher in observation group （ （ 74. 18± 25.98）, （ 114.94± 17.83 ）, （ 88.13±21.39 ）, （69.66±12. 13）/mm2） than those in control group （（33.47±8.32）, （36.70±7.71�

关 键 词：缺血皮瓣 低剂量X线照射 血管内皮生长因子 基质金属蛋白酶-9 大鼠 

分 类 号：R622[医药卫生—整形外科]