小牛血清去蛋白注射液促进缺血皮瓣成活的实验研究  

Experimental study of deproteinized calf blood serum injection in augmenting the survival of ischemic flap

作　　者：唐明杰[1] 章程 贾亚超[1] 孙玉强[1] 柴益民[1] TANG Mingjie;ZHANG Cheng;JIA Yachao;SUN Yuqiang;CHAI Yimin(Department of Orthopedics, the Sixth People′s Hospital Affiliated to Shanghai Jiaotong University, Shanghai 200233, China)

机构地区：[1]上海交通大学附属第六人民医院骨科,200233

出　　处：《国际骨科学杂志》2021年第5期315-318,共4页International Journal of Orthopaedics

摘　　要：目的 探讨小牛血清去蛋白注射液对缺血皮瓣成活面积的影响及可能机制。方法 36只SD大鼠随机分为3组,在背部建立3cm×10cm缺血皮瓣模型。分别于术后当天经腹腔注射不同药物:实验1组给予小牛血清去蛋白注射液30mg/kg治疗,实验2组给予小牛血清去蛋白注射液45mg/kg治疗,对照组给予等量生理盐水注射。2周后对皮瓣成活率及组织学进行检测,并对坏死边界组织成血管和凋亡相关基因进行检测。结果 实验1组和2组皮瓣成活率分别为62.2%±6.3%和64.9%±3.5%,均显著优于对照组的47.8%±1.7%(P<0.01)。实验1组和2组新生血管标记物CD31、CD34、vWF密度显著高于对照组(P<0.01)。实验1组和2组凋亡指标BCL-2及BAX基因表达较对照组显著下调(P<0.05),而3组中成血管基因eNOS表达无显著性差异(P>0.05)。结论 小牛血清去蛋白注射液可下调缺血皮瓣凋亡基因表达水平,改善皮瓣缺血状态下细胞能量代谢,从而促进皮瓣新生血管生成,增加缺血皮瓣成活面积。Objective This study aimed to investigate the efficacy and possible mechanism through which deproteinized calf blood serum injection prolongs ischemic flap survival.Methods Thirty-six Sprague-Dawley rats were randomly divided into three groups.A distally based random flap 3 cm×10 cm in size was elevated on the rats′backs.After the flap surgery,deproteinized calf blood serum injection in 30 mg/kg and 45 mg/kg doses was administered through intraperitoneal injection in groupsⅠandⅡ,respectively.In groupⅢ,saline was administered as a control.At 2 weeks postoperatively,the flap survival rate was calculated,and the flaps were evaluated by histological examination.The vessel distribution and apoptosis of associated genes in the flap were also investigated.Results The flap survival area was 62.2%±6.3%and 64.9%±3.5%in groupsⅠandⅡ,respectively,which was significantly greater than in groupⅢ,at 47.8%±1.7%(P<0.01).The density of CD31,CD 34,and vWF in the flaps was significantly higher in groupsⅠandⅡcompared to groupⅢ(P<0.01).The expression of BCL-2 and BAX decreased significantly in groupsⅠandⅡcompared to groupⅢ(P<0.05).No significant difference was found in eNOS expression among groups(P>0.05).Conclusion The deproteinized calf blood serum injection decreased the expression of apoptosis-associated genes and improved energy metabolism in the ischemic flap,resulting in better angiogenesis in the ischemic flaps and improving the survival rate.

关 键 词：外科皮瓣 缺血 小牛血清去蛋白液 成活 能量代谢 

分 类 号：R73[医药卫生—肿瘤]