發(fā)布時(shí)間：2018-07-25 16:55

【摘要】：目的觀察并探討水蛭素對(duì)皮瓣遠(yuǎn)端缺血組織血流灌注量及新生血管形成的影響及其相關(guān)機(jī)制。方法于每只SD大鼠背部構(gòu)建2個(gè)8cm×2cm缺血皮瓣。將左右皮瓣隨機(jī)分為水蛭素組與對(duì)照組,術(shù)后即刻(設(shè)為第0天)和術(shù)后第1、2、3天于皮瓣近、中、遠(yuǎn)段各位點(diǎn)分別給予皮下注射0.5ATU水蛭素及等量生理鹽水對(duì)照,分別以激光多普勒血流成像儀、免疫組織化學(xué)法、及Western Blot檢測(cè)每日皮瓣血流灌注狀態(tài)、微血管密度(Microvessel density,MVD)、血管內(nèi)皮細(xì)胞生長(zhǎng)因子(vascular endothelial growth factor,VEGF)和血小板凝血酶敏感蛋白-1(thrombospondin-1,TSP-1)的蛋白表達(dá)水平,并于術(shù)后第6天測(cè)定皮瓣成活面積。結(jié)果術(shù)后第1-6天,水蛭素組皮瓣血流灌注量及VEGF表達(dá)水平顯著高于對(duì)照組(P0.05);術(shù)后早期MVD在兩組間無明顯差異,至第4天水蛭素組MVD明顯高于對(duì)照組(P0.01);術(shù)后第1-4天,水蛭素組皮瓣組織中TSP-1表達(dá)量明顯低于對(duì)照組(P0.01);水蛭素組皮瓣成活面積顯著大于對(duì)照組(P0.01)。結(jié)論水蛭素通過加速恢復(fù)血流灌注、調(diào)節(jié)血管生成相關(guān)因子、促進(jìn)缺血皮瓣新生血管形成,從而提高皮瓣組織的成活。
[Abstract]:Objective to investigate the effect of hirudin on blood flow and angiogenesis in distal ischemic skin flap. Methods two 8cm 脳 2cm ischemic flaps were constructed on the back of each SD rat. The left and right flaps were randomly divided into hirudin group and control group. Immediately after operation (day 0) and 2 days after operation, the flaps were treated with subcutaneous injection of 0.5ATU hirudin and the same amount of normal saline respectively. The blood perfusion status of the skin flap was measured by laser Doppler flow imaging, immunohistochemical method and Western Blot, respectively. The expression of Microvessel density, vascular endothelial growth factor (vascular endothelial growth) and thrombospondin-1 (TSP-1) were measured on the 6th day after operation. Results the blood perfusion volume and VEGF expression of hirudin group were significantly higher than those of control group (P0.05), but the MVD of hirudin group was significantly higher than that of control group (P0.01) at the 4th day after operation (P0.05), and the level of MVD in hirudin group was significantly higher than that in control group (P0.01) at the 4th day after operation. The expression of TSP-1 in hirudin group was significantly lower than that in control group (P0.01), and the survival area of hirudin group was significantly larger than that of control group (P0.01). Conclusion hirudin can accelerate the recovery of blood flow, regulate the angiogenesis related factors, promote angiogenesis of ischemic flap, and improve the survival of skin flap.
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R622

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本文編號(hào)：2144451