二甲基乙二酰基甘氨酸对跨区穿支皮瓣Choke Ⅱ区血管生成的影响机制研究  

Effect of dimethyloxalylglycine on angiogenesis in Choke Ⅱ zone of cross-zone perforator flap and its mechanism

作　　者：曾秀安 厉孟 杨其兵 汪其苑 陈永新 罗想利[2] 李继东 蓝旭 ZENG Xiuan;LI Meng;YANG Qibing;WANG Qiyuan;CHEN Yongxin;LUO Xiangli;LI Jidong;LAN Xu(The First Clinical Medical College of Gansu University of Traditional Chinese Medicine,Lanzhou Gansu,730000,P.R.China;The Fifth Department of Orthopedics,Gansu Provincial People’s Hospital,Lanzhou Gansu,730000,P.R.China)

机构地区：[1]甘肃中医药大学第一临床医学院,兰州730000 [2]甘肃省人民医院骨五科,兰州730000

出　　处：《中国修复重建外科杂志》2022年第2期224-230,共7页Chinese Journal of Reparative and Reconstructive Surgery

基　　金：全军后勤科研计划面上项目(CLZ13J003)。

摘　　要：目的研究二甲基乙二酰基甘氨酸(dimethyloxalylglycine,DMOG)对跨区穿支皮瓣Choke Ⅱ区血管生成的影响及作用机制。方法将126只成年雄性SD大鼠随机分为DMOG组、YC-1组和空白对照组,每组42只。3组大鼠背部制作大小为12 cm×3 cm的跨区穿支皮瓣模型;于术前1 d、2 h及术后1、2、3 d分别腹腔注射DMOG(40 mg/kg)、YC-1(HIF-1α抑制剂,10 mg/kg)和等量生理盐水。术后观察各组大鼠皮瓣成活情况,7 d时测量皮瓣成活面积并计算皮瓣成活率,皮瓣透光实验、明胶-氧化铅血管造影及HE染色观察皮瓣Choke Ⅱ区血管生成情况,免疫组织化学染色及Western blot法检测皮瓣Choke Ⅱ区VEGF及HIF-1α表达;3、5、7 d ELISA法测定皮瓣Choke Ⅱ区VEGF和HIF-1α蛋白含量。结果术后7 d时DMOG组皮瓣远端未见明显坏死,空白对照组和YC-1组皮瓣均发生坏死且主要位于远端;DMOG组皮瓣成活率为90.28%±1.37%,高于YC-1组84.28%±1.45%及空白对照组85.83%±1.60%,差异有统计学意义(P<0.05)。DMOG组皮瓣Choke Ⅱ区血管较多且结构清晰、完整;YC-1组、空白对照组中Choke Ⅱ区血管较少且结构紊乱。DMOG组血管数量为(25.56±1.29)条/视野,高于YC-1组(7.38±0.54)条/视野及空白对照组(14.48±0.91)条/视野,差异有统计学意义(P<0.05)。术后3、5、7 d,DMOG组皮瓣Choke Ⅱ区HIF-1α、VEGF表达均高于其余两组,差异有统计学意义(P<0.05)。结论 DMOG能促进跨区穿支皮瓣Choke Ⅱ区血管生成,加速皮瓣早期血管化进程,改善微循环和血供,降低皮瓣缺血、缺氧损伤程度,提高成活率。Objective To study the effect of dimethyloxalylglycine(DMOG) on angiogenesis in Choke Ⅱ zone of rats cross-zone perforator flaps and its mechanism. Methods One hundred and twenty-six adult male Sprague Dawley rats were randomly divided into DMOG group, YC-1 group, and control group, with 42 rats in each group. Crosszone perforator flap model with size of 12 cm×3 cm was made on the back of rats in the three groups. DMOG group was intraperitoneally injected with DMOG(40 mg/kg) at 1 day before operation, 2 hours before operation, and 1, 2, and3 days after operation;YC-1 group and control group were intraperitoneally injected with YC-1(10 mg/kg) and the same amount of normal saline at the same time points, respectively. The survival of flap was observed after operation. At 7 days after operation, the survival area of flap in each group was measured and the survival rate of flap was calculated. Flap transmittance test, gelatin-lead oxide angiography, and HE staining were used to observed the angiogenesis in the Choke Ⅱ zone of flaps in each group. Immunohistochemical staining and Western blot were used to detect the expressions of vascular endothelial growth factor(VEGF) and hypoxia-inducible factor 1α(HIF-1α) in Choke Ⅱ zone of flaps in each group. The expressions of VEGF and HIF-1α were also determined by ELISA at 3, 5, and 7 days. Results At 7 days after operation, there was no obvious necrosis at the distal end of the flap in DMOG group, while necrosis occurred in both the control group and YC-1 group, mainly located at the distal end. The flap survival rate of DMOG group was 90.28%±1.37%,which was significantly higher than that of YC-1 group(84.28%±1.45%) and control group(85.83%±1.60%)(P<0.05).DMOG group had more angiogenesis in Choke Ⅱ zone and the vascular structure was clear and complete. In YC-1 group and control group, the vessels in Choke Ⅱ zone was less and the vascular structure was disordered. The number of vessels was(25.56±1.29)/field in the DMOG group, which was significantly higher

关 键 词：跨区穿支皮瓣 ChokeⅡ区 血管生成 二甲基乙二酰基甘氨酸 大鼠 

分 类 号：R965[医药卫生—药理学]