雌激素對脂肪移植血管化的影響
發(fā)布時間：2018-08-08 16:56
【摘要】：背景:20世紀(jì)至今,自體脂肪移植逐漸被人民群眾和外科醫(yī)生所認(rèn)可,廣泛應(yīng)用到美容整形的各個領(lǐng)域,如治療面部凹陷,隆乳術(shù)等[1-10]。1893年,Neuber首先報道了將上臂脂肪移植填充面部的案例[11]。隨著技術(shù)的提升,自體脂肪移植又逐漸用于癌癥術(shù)后重建,硬皮病,重度皺紋,修復(fù)瘢痕等領(lǐng)域[12-17]。自體脂肪移植術(shù),是指在人體自身脂肪較豐富的部位,用一定方法抽吸脂肪組織,然后運(yùn)用一些方法處理成純凈的脂肪顆粒,將其注射植入需要改變的有缺陷的部位,通過脂肪組織的增生,從而完善受區(qū)形態(tài)的一種手術(shù)方法。許多國內(nèi)學(xué)者研究表明,促進(jìn)移植脂肪內(nèi)部血供重建,獲得有效的組織血液灌流,縮短脂肪組織的低血期,為各種細(xì)胞因子作用提供保障,可促進(jìn)前脂肪細(xì)胞向脂肪細(xì)胞分化,對提高移植體存活具有重要意義[18]。早期能否及時建立血供對移植脂肪的成活至關(guān)重要[19]。因此較多學(xué)者利用各種細(xì)胞因子來促進(jìn)脂肪移植體早期血運(yùn)重建,然而細(xì)胞因子的流失和作用時間具有不確定性。目的:探討更年期雌激素以及雌激素替代療法對脂肪移植存活效果的影響。研究方法和結(jié)果:取SD大鼠40只,行背部雙側(cè)切口雙側(cè)卵巢摘除術(shù),連續(xù)一周取其陰道分泌物,確認(rèn)動情周期消失,即造模成功。將絕經(jīng)大鼠按照體重排序,隨機(jī)抽樣分為四組。雌激素替代組A組(n=10):脂肪移植前后均進(jìn)行苯甲酸雌二醇替代;雌激素替代組B組(n=10):卵巢切除后脂肪移植前未予替代,移植后行苯甲酸雌二醇替代;雌激素替代組C組(n=10):卵巢切除后脂肪移植前苯甲酸雌二醇替代,移植后停用;空白組D組(n=10):移植前后不予雌激素應(yīng)用。行雌激素替代和生理鹽水對照45天后,檢測大鼠雌激素水平,無菌操作下抽取腹股溝脂肪組織2-3ml,經(jīng)漂洗離心后,分別移植到SD大鼠背部皮下。術(shù)后按照分組處理,繼續(xù)飼養(yǎng)45天。45天后,處死各組大鼠,完整取出移植物,通過大體觀察,石蠟切片HE染色組織學(xué)觀察,RT-PCR半定量檢測VEGF及免疫組化檢測雌激素受體α,觀察移植脂肪存活的效果。結(jié)論:研究發(fā)現(xiàn),脂肪移植前予以雌激素替代治療有利于脂肪組織的存活,成活率較高;雌激素可促進(jìn)雌激素受體α的表達(dá),雌激素通過與受體結(jié)合,促進(jìn)VEGF的表達(dá),VEGF可促進(jìn)移植脂肪體內(nèi)微血管生成。脂肪移植術(shù)后予以雌激素替代治療,無助于脂肪組織的再血管化;絕經(jīng)大鼠行脂肪移植后,脂肪體積保留較多,但血管密度相較于雌激素替代較低,遠(yuǎn)期存活效果不如雌激素替代組;術(shù)前應(yīng)用雌激素,優(yōu)于術(shù)后應(yīng)用雌激素。
[Abstract]:Background: since the 20th century, autogenous fat transplantation has been accepted by people and surgeons, and has been widely used in various fields of cosmetic and plastic surgery, such as the treatment of facial depression. Breast augmentation [1-10]. Neuber first reported a case of facial implants with upper arm fat graft in 1893 [11]. With the development of technology, autologous fat transplantation has been gradually used in the fields of cancer reconstruction, scleroderma, severe wrinkles, scar repair and so on [12-17]. Autologous fat transplantation refers to the use of certain methods to draw fat tissue in parts of the human body that are rich in fat, and then use some methods to treat it into pure fat granules and inject them into defective parts that need to be changed. A surgical method for improving the morphology of the recipient area through the proliferation of adipose tissue. Many domestic scholars have shown that promoting the reconstruction of blood supply in adipose tissue, obtaining effective tissue hemoperfusion, shortening the low blood phase of adipose tissue, providing protection for the action of various cytokines, and promoting the differentiation of preadipocytes into adipocytes. It is of great significance to improve the survival of grafts [18]. Early establishment of blood supply is crucial to the survival of fat grafts [19]. Therefore, many scholars use various cytokines to promote the early revascularization of fat grafts, but the loss and duration of cytokines are uncertain. Objective: to investigate the effect of menopausal estrogen and estrogen replacement therapy on the survival of fat transplantation. Methods and results: 40 Sprague-Dawley (SD) rats were treated with bilateral ovariectomies through bilateral dorsal incision. Vaginal secretions were removed for one week to confirm that the estrus cycle disappeared and the model was established successfully. The postmenopausal rats were randomly divided into four groups according to their body weight. Estradiol benzoate (estradiol benzoate) was used before and after fat transplantation in estrogen replacement group A (n = 10), and estradiol benzoate was used in estrogen replacement group B (n = 10) before and after ovariectomized fat transplantation. Estradiol benzoate (estradiol benzoate) was substituted before ovariectomy and stopped after transplantation in group C (n = 10), while group D (n = 10) did not use estrogen before and after ovariectomy. After 45 days of estradiol replacement and physiological saline control, estrogen levels were measured. The inguinal adipose tissue was extracted 2 ~ 3 ml under aseptic operation. After rinsing and centrifugation, it was transplanted to the subcutaneous part of the back of SD rats. After 45 days of feeding, the rats were killed, the grafts were removed completely, and the grafts were taken out. Paraffin sections were stained with HE staining to observe the semi-quantitative detection of VEGF by RT-PCR and estrogen receptor 偽 by immunohistochemistry to observe the survival of fat grafts. Conclusion: estrogen replacement therapy before fat transplantation is beneficial to the survival of adipose tissue and its survival rate is higher. Estrogen can promote the expression of estrogen receptor 偽 and estrogen binds to estrogen receptor. Promoting the expression of VEGF can promote microangiogenesis in adipose tissue. Estrogen replacement therapy after fat transplantation was not helpful to the vascularization of adipose tissue. After fat transplantation, the fat volume of postmenopausal rats remained more, but the vascular density was lower than that of estrogen replacement. The long-term survival effect was not as good as that in estrogen replacement group, and the application of estrogen before and after operation was better than that of estrogen after operation.
【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R622
本文編號：2172424
[Abstract]:Background: since the 20th century, autogenous fat transplantation has been accepted by people and surgeons, and has been widely used in various fields of cosmetic and plastic surgery, such as the treatment of facial depression. Breast augmentation [1-10]. Neuber first reported a case of facial implants with upper arm fat graft in 1893 [11]. With the development of technology, autologous fat transplantation has been gradually used in the fields of cancer reconstruction, scleroderma, severe wrinkles, scar repair and so on [12-17]. Autologous fat transplantation refers to the use of certain methods to draw fat tissue in parts of the human body that are rich in fat, and then use some methods to treat it into pure fat granules and inject them into defective parts that need to be changed. A surgical method for improving the morphology of the recipient area through the proliferation of adipose tissue. Many domestic scholars have shown that promoting the reconstruction of blood supply in adipose tissue, obtaining effective tissue hemoperfusion, shortening the low blood phase of adipose tissue, providing protection for the action of various cytokines, and promoting the differentiation of preadipocytes into adipocytes. It is of great significance to improve the survival of grafts [18]. Early establishment of blood supply is crucial to the survival of fat grafts [19]. Therefore, many scholars use various cytokines to promote the early revascularization of fat grafts, but the loss and duration of cytokines are uncertain. Objective: to investigate the effect of menopausal estrogen and estrogen replacement therapy on the survival of fat transplantation. Methods and results: 40 Sprague-Dawley (SD) rats were treated with bilateral ovariectomies through bilateral dorsal incision. Vaginal secretions were removed for one week to confirm that the estrus cycle disappeared and the model was established successfully. The postmenopausal rats were randomly divided into four groups according to their body weight. Estradiol benzoate (estradiol benzoate) was used before and after fat transplantation in estrogen replacement group A (n = 10), and estradiol benzoate was used in estrogen replacement group B (n = 10) before and after ovariectomized fat transplantation. Estradiol benzoate (estradiol benzoate) was substituted before ovariectomy and stopped after transplantation in group C (n = 10), while group D (n = 10) did not use estrogen before and after ovariectomy. After 45 days of estradiol replacement and physiological saline control, estrogen levels were measured. The inguinal adipose tissue was extracted 2 ~ 3 ml under aseptic operation. After rinsing and centrifugation, it was transplanted to the subcutaneous part of the back of SD rats. After 45 days of feeding, the rats were killed, the grafts were removed completely, and the grafts were taken out. Paraffin sections were stained with HE staining to observe the semi-quantitative detection of VEGF by RT-PCR and estrogen receptor 偽 by immunohistochemistry to observe the survival of fat grafts. Conclusion: estrogen replacement therapy before fat transplantation is beneficial to the survival of adipose tissue and its survival rate is higher. Estrogen can promote the expression of estrogen receptor 偽 and estrogen binds to estrogen receptor. Promoting the expression of VEGF can promote microangiogenesis in adipose tissue. Estrogen replacement therapy after fat transplantation was not helpful to the vascularization of adipose tissue. After fat transplantation, the fat volume of postmenopausal rats remained more, but the vascular density was lower than that of estrogen replacement. The long-term survival effect was not as good as that in estrogen replacement group, and the application of estrogen before and after operation was better than that of estrogen after operation.
【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R622
【參考文獻(xiàn)】
相關(guān)期刊論文 前10條
1 劉柏炎;宋曉玲;易健;陳雪梅;;雌二醇對去勢大鼠局灶性腦缺血后小窩蛋白-1和血管內(nèi)皮生長因子表達(dá)的影響[J];中國老年學(xué)雜志;2016年10期
2 余泮熹;蔡景龍;;自體脂肪注射移植在瘢痕治療中的研究進(jìn)展[J];中國醫(yī)學(xué)科學(xué)院學(xué)報;2016年02期
3 秦曉;魯樹榮;梁軍;黃小林;;自體脂肪移植重塑顴部脂肪墊的臨床效果[J];中華醫(yī)學(xué)美學(xué)美容雜志;2016年02期
4 王陽;陳波;王曉軍;;自體脂肪移植綜合技術(shù)矯正面部局限性硬皮病[J];組織工程與重建外科雜志;2016年01期
5 黃皎;于湄;田衛(wèi)東;;脂肪組織血管基質(zhì)成分在組織工程化脂肪構(gòu)建中的應(yīng)用[J];國際口腔醫(yī)學(xué)雜志;2016年01期
6 伍博;曠翎;張騰;賈曉敏;馮浩;;小鼠脂肪移植后脂肪細(xì)胞及脂肪組織的組織學(xué)和超微結(jié)構(gòu)變化[J];軍事醫(yī)學(xué);2015年11期
7 唐慧;張文麗;朱瑩;張茜;王瑞敏;;雌激素通過上調(diào)VEGF表達(dá)降低大鼠腦慢性低灌注誘導(dǎo)的微血管損傷[J];南方醫(yī)科大學(xué)學(xué)報;2015年11期
8 傘光;宋佳;;血小板衍生內(nèi)皮細(xì)胞生長因子轉(zhuǎn)染脂肪間充質(zhì)干細(xì)胞促進(jìn)移植脂肪血管化[J];中國組織工程研究;2015年41期
9 郭莉;謝淼;康彥玲;吳小會;高慧;趙愛群;李燕;;自體脂肪顆粒移植在面部輪廓整形中的臨床應(yīng)用[J];河北醫(yī)藥;2015年09期
10 鄧婷;顏玲;;雌激素對脂肪的影響研究進(jìn)展[J];中國臨床解剖學(xué)雜志;2015年02期
相關(guān)碩士學(xué)位論文 前1條
1 陳昕;雌激素對大鼠脂肪干細(xì)胞誘導(dǎo)成骨成脂分化影響的研究[D];第四軍醫(yī)大學(xué);2010年
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