摘要
目的探讨尾静脉注射二甲氧乙二酰甘氨酸（DMOG）对大鼠背部跨区皮瓣血管体吻合区（choke血管区）微循环以及皮瓣成活率的影响。方法2015年2月至2015年9月，将40只SD大鼠随机分成DMOG实验组和生理盐水对照组，在背部右侧，切取以髂腰动脉为蒂，其远端跨越肋间后动脉，延伸至胸背动脉体区，制备9cm×3cm跨区皮瓣。实验组于皮瓣切取前1d、术后即刻、术后1、2、3d尾静脉注射DMOG40mg／kg，对照组于相同时间点尾静脉注射等量的生理盐水。①Choke区术后1、3、7d取材，HE染色，光镜下观察同一部位动、静脉管径形态，并计算两组管径大小改变的相对值。②术后7d，Western blot检测皮肤相关蛋白PCNA和HIF—1α表达水平；ELISA检测皮肤PCNA、HIF-1α、SDF—1α和VEGF含量。③术后7d处死大鼠，统计皮瓣成活率以及血管造影观察皮瓣微血管形态。结果①实验组、对照组皮瓣术后7d的成活率分别为（96．3±5．1）％和（73．9±5．8）％，实验组显著高于对照组（t=6．528，P〈0．05）。②X线显示实验组髂腰动脉明显比对照组增粗增长，与术前相比，实验组和对照组于术后1、3、7d时动、静脉管径逐渐扩大：术后1d，实验组和对照组管径扩大倍数为1．40±0．01和1．27±0．15，差异无统计学意义（P〉0．05）；术后3d．实验组和对照组管径扩大倍数为2．20±0．26和1．50±0．20，差异有统计学意义（t=3．656，P〈0．05）；术后7d，实验组和对照组管径扩大倍数为3．67±0．35和2．03±0．15，差异有统计学意义（t=7．387，P〈O．05）。③术后7d，实验组皮肤PCNA、HIF—1α表达明显高于对照组，差异有统计学意义（P〈0．05）。④术后第7天，实验组和对照组皮肤PCNA的蛋白含量为（8．95±0．71）ng／mg和（4．15±0．72）ng／mg，HIF—1α的蛋白含量为（5．04±0．50）ng／mg和（2．98±0．29）ng／mg，SDF-1α的蛋白含量（2．91±0．61）ng／mg和（1．39±0．62）ng／mg，VEGF的蛋白含量为（2．17±0．41）ng／mg和（0．95±0．44）ng／mg，实验组均高于对照组，差异均有统计学意义（P〈0．05）。结论尾静脉注射DMOG通过改善皮瓣穿支血管体choke区微循环，减轻皮瓣缺血、缺氧的损伤，从而提高皮瓣成活率。
Objective To investigate the effects of DMOG on the microcirculation of the choke-area and the survival of the cross-boundary flap in rats via tail vein injection. Methods Rats with ischemic three-territory perforator flaps on the dorsum were treated with DMOG at a dosage of 40 mg/kg body weight via tail vein injection at 1 day before surgery （day- 1 ）, the time of surgery （day 0）, 1 day after surgery （day 1 ）, 2 days after surgery （day 2） and 3 days after surgery（day 3）. Control group received sterile saline at the same time points and same dosage via tail vein injection. ①Draw materials from the choke-area at day 1, day 3 and day 7, HE stain was used to compare the diameter size of the artery and vein at the same site. ② Western blotting to check the expression of PCNA and HIF-1α, ELISA to detect the content of PCNA, HIF-1α, SDF-1α and VEGF at day 7. ③At day 7, measure the survival area of the flap and observe the vessel of the flap by lead oxide-gelatine technique. Results ① There was a greater survival rate of （96.3 ± 5.1）% in the treatment group than in the control group with （73.9 ± 5.8）% at day 7 （P 〈 0.05）. ② The diameter size of the arterioles and venules were dilated in both groups until postoperative days 7. But the treatment group was more expanded than the control group at day 3（2.20± 0.26 vs. 1.50 ± 0.20, P 〈 0.05） and day 7（3.67± 0.35 vs. 2.03 ± 0.15,P 〈 0.05）. ③The skin expression of PCNA and HIF-1α in the treatment group were greater than the control group（P 〈 0.05） at day 7. ④ The content of skin PCNA in the treat- ment group and control group were（8.95 ±0.71） ng/mg and （4.15 ± 0.72） rig/rag, HIF-1α were（5.04 ± 0.50） ng/mg and （2.98 ± 0.29） ng/mg, SDF-1α were （2.91 ± 0.61） ng/mg and （1.39±0.62） ng/mg, and VEGF were（2.17 ± 0.41 ） ng/mg and （0.95± 0.44） ng/mg, respectively. The treatment group was greater than the control group （P 〈 0.05）. Conclusion DMOG can improve the microcirculation of the choke area, and then increase the survival of the perforator skin flaps in rats via tail vein injection.
出处
《中华显微外科杂志》
CSCD
北大核心
2016年第2期143-147,共5页
Chinese Journal of Microsurgery
基金
国家自然科学基金（31371214,81472104）
浙江省自然科学基金（LY13H150008,LY14H150009）
温州市科技局计划项目（Y20140001）
