内皮抑素对犬胃癌术后胃肠吻合口愈合的影响  

Effects of tumor angiogenesis inhibitor endostatin on healing of gastrointestinal anastomoses in dogs

作　　者：张国锋[1] 罗芸葆[2] 郭义君[2] 王元和[1] 王强[1] 

机构地区：[1]第二军医大学长征医院普通外科,上海200003 [2]上海浦东新区人民医院普通外科,上海201200

出　　处：《第二军医大学学报》2004年第2期176-178,共3页Academic Journal of Second Military Medical University

基　　金：上海浦东新区科技专项资金项目 ( PK2 0 0 1-11)

摘　　要：目的 :研究肿瘤血管生成抑制剂内皮抑素 (endostatin)对胃癌术后胃肠吻合口愈合的影响。方法 :将 2 8只犬行模拟胃癌根治术 ,术后随机分为 4组 ,每组 7只。对照组犬不予以药物 ;另 3组于手术当天起 ,分别自腹腔注射 :5 -氟脲嘧啶 (2 5mg· kg- 1 · d- 1 ,5 - Fu组 ) ,内皮抑素 (1 5 mg· kg- 1 · d- 1 ,内皮抑素组 ) ,5 - Fu与内皮抑素联合应用 (5 - Fu 2 5 mg· kg- 1 · d- 1 ,内皮抑素 1 5 m g· kg- 1 · d- 1 ,联用组 ) ,共 1 0 d。检测各组吻合口破裂压、羟脯氨酸含量、组织病理学改变和胶原纤维超微结构变化。结果 :术后第 1 0天 ,所有动物再次剖腹探查 ,均无吻合口瘘的发生。对照组、5 - Fu组、内皮抑素组、联用组的吻合口破裂压分别为 (36 .5± 6 .7)、(31 .5± 4 .9)、(32 .3± 6 .2 )、(30 .4± 5 .3) k Pa;羟脯氨酸含量分别为 (1 5 .3± 3.7)、(1 4 .7± 2 .9)、(1 2 .9± 3.1 )、(1 3.1± 3.8) ;组间均无显著性差异。组织病理学检查结果显示各组吻合口愈合良好 ,有胃或十二指肠黏膜上皮移行。电镜下 ,各组吻合口组织均见胶原纤维交叉紧密排列 ,其间有大量成纤维细胞。结论Objective:To investigate the effects of tumor angiogenesis inhibitor endostatin on healing of gastrointestinal anastomoses in the dog. Methods: An imitative radical gastrectomy was performed and a gastrointestinal anastomosis was constructed in 28 dogs. Animals were randomly divided into 4 groups ( n =7) and were given different daily intraperitoneal treatment for 10 d as follows: the control group: received nothing; the 5 Fu 15 group: received 5 Fu (25 mg·kg·d -1 ); the endostatin group: received endostatin (15 mg·kg·d -1 ); the combined treatment group: received both 5 Fu and endostatin (5 Fu 25 mg·kg·d -1 , endostatin 15 mg·kg·d -1 ). The influence of endostatin on healing of gastrointestinal anastomoses was studied by observing and comparing the anastomosis bursting pressure, hydroxyproline content, histopathologic and ultrastructure changes in different groups. Results: On the 10th postoperative day, no anastomotic leakage was found in the second look operation. The average anastomosis bursting pressure in the control group, 5 Fu group, endostatin group and combined treatment group were (36.5±6.7), (31.5±4.9), (32.3±6.2) and (30.4±5.3) kPa; the contents of hydroxyproline in each group were (15.3±3.7), (14.7±2.9), (12.9±3.1) and (13.1±3.8) respectively. The histopathologic observation showed good healing in all gastrointestinal anastomoses. Conclusion: Tumor angiogenesis inhibitors endostatin has no adverse effects on the healing and resistance of gastrointestinal anastomoses.

关 键 词：内皮抑素 犬 胃癌 术后 胃肠吻合口愈合 血管生成抑制剂 

分 类 号：R735.7[医药卫生—肿瘤] R73-36[医药卫生—临床医学]