含血管内皮生长因子缓释微粒显微缝线促进大鼠小血管吻合后的内皮再生  

Application of microsutures with vascular endothelial growth factor to improve vascular endothelial regeneration after small vessel anastomosis in the rats

作　　者：张铁慧[1] 梁武[1] 任远飞[1] 董玉金[1] 杨文峰[1] 尚耀华[1] 李巨涛 钟声[1] Zhang Tie-hui;Liang Wu;Ren Yuan-fei;Dong Yu-jin;Yang Wen-feng;Shang Yao-hua;Li Ju-tao;Zhong Sheng(Department of Hands and Feet Microsurgery,Dalian Municipal Central Hospital,Dalian 116033,Liaoning Province,China)

机构地区：[1]大连市中心医院手足外一科,辽宁省大连市116038

出　　处：《中国组织工程研究》2018年第6期877-882,共6页Chinese Journal of Tissue Engineering Research

基　　金：大连市科技局课题(2015E21SF008)~~

摘　　要：背景:血管内皮生长因子具有成血管作用,目前国内构建血管内皮生长因子缓释微粒缝线预防血管吻合术后并发症方面的报道较少。目的:合成含血管内皮生长因子的缓释微粒缝线,评估其对大鼠小血管吻合后血管再生的作用。方法:采用乳化分散法制备包裹血管内皮生长因子的可生物降解高分子聚乳酸/乙醇酸共聚物微粒,将其负载于显微缝线中,制备含血管内皮生长因子缓释微粒显微缝线。取90只SD大鼠,制作尾动脉血管吻合模型,随机分2组,实验组采用含血管内皮生长因子缓释微粒显微缝线进行吻合,对照组采用普通显微缝线进行吻合,吻合后2 h、12 h、1 d、3 d、7 d,观察两组并发症发生情况、外周血血管内皮生长因子水平及血管吻合处苏木精-伊红染色结果。结果与结论:(1)并发症情况:实验组术后皮肤坏死发生率明显小于对照组(P<0.05);(2)血管内皮生长因子水平:实验组术后不同时间点的外周血血管内皮生长因子水平均高于对照组(P<0.05);(3)苏木精-伊红染色:实验组血管吻合后1 d,吻合口缝线附近可见增生的内皮细胞;吻合后3 d,小血管吻合口两端缝线附近可见大量增生的内皮细胞和内皮下组织,完成覆盖缝线;吻合后1周,内皮细胞及内弹性膜修复完全,平滑肌细胞进一步增生,外膜恢复正常。对照组血管吻合后1 d,吻合口缝线附近表现为创伤后细胞变性坏死,仅外膜层细胞浸润并呈创伤性增生反应;吻合后3 d,内皮细胞脱落区出现新生内皮细胞,并出现生长移行,吻合口开始有少量内皮细胞覆盖;吻合后5-7 d,新生的内皮细胞爬过吻合口裂隙并覆盖缝线;(4)结果表明:含血管内皮生长因子缓释微粒显微缝线可促进大鼠小血管吻合内皮的再生。BACKGROUND:The vascular endothelial growth factor(VEGF)plays an important role in the development and formation of blood vessels.Up to now,there are few reports about the treatment of postoperative complications of vascular anastomosis surgery by mcrosutures with VEGF in China.OBJECTIVE:To synthesiize microsutures with VEGF and to evaluate its effect in revascularization following small vessel anastomosis.METHODS:The method of emulsification-diffusion was use to produce biodegradable polymer polylactic acid/glycolic acid(PLGA)copolymer microparticles containing VEGF,and then,the microparticles were added into microsutures to prepare microsutures with VEGF.Ninety Sprague-Dawley rats were enrolled to make animal models of caudal artery anastomosis using microsutures with VEGF in experimental group and microsutures alone in control group.Complications and VEGF level in the peripheral blood were detected and hematoxylin-eosin staining at the anastomotic site was performed at 2,12 hours,1,3,7 days after anastomosis.RESULTS AND CONCLUSION:(1)Postoperative complications:The postoperative incidence of skin necrosis was significantly lower in the experimental group than the control group(P<0.05).(2)VEGF level:Compared with the control group,the peripheral blood VEGF level was significantly higher in the experimental group at each time point after operation(P<0.05).(3)Hematoxylin-eosin staining:In the experimental group,proliferated endothelial cells were seen near the anastomotic site at 1 day after anastomosis;there were a large number of proliferated endothelial cells and subcutaneous tissues covering the sutures completely at 3 days after anastomosis;and endothelial cells and internal elastic lamina were completely repaired,smooth muscle cells proliferated further,and the outer membrane returned to normal at 1 week after anastomosis.In the control group,cell degeneration and necrosis were seen near the anastomotic suture,and only adventitial cells infiltrated and exhibited a traumatic proliferative response at 1 day af

关 键 词：血管内皮生长因子类 显微外科手术 微粒体 组织工程 

分 类 号：R318[医药卫生—生物医学工程]