【摘要】：目的:探討低劑量X射線照射(Low-Dose Irradiation,LDI)對缺血皮瓣成活的影響及其可能的機制。方法:2014年6月至2014年12月,選取SD大鼠80只,將大鼠隨機分為2組,每組40只,分別為實驗組A、對照組B。于大鼠背部逆行掀起1個長寬為9 cm×3 cm的蒂部靠尾側(cè)的缺血隨意皮瓣,將經(jīng)消毒處理的生物隔離膜墊于皮瓣下以阻斷肌層與皮瓣的血供聯(lián)系,然后原位間斷縫合。A組皮瓣術(shù)后立即給予總劑量值為0.2 Gy的低劑量X射線單次局部照射,B組術(shù)后不予照射。術(shù)后1-14d分別對兩組皮瓣行大體觀察、組織HE染色和Western-Blot檢測,計算皮瓣成活率、微血管新生情況以及皮瓣中VEGF和MMP-9的含量。結(jié)果:術(shù)后3d、7d以及14d實驗組皮瓣成活率分別為(66.46±4.37)%、(44.30±3.86)%、(32.20±4.22)%,均高于對照組(43.15±5.03)%、(27.71±3.20)%、(16.40±5.34)%,差異有顯著統(tǒng)計學(xué)意義(P0.01)。HE染色實驗組皮瓣內(nèi)可見成纖維細(xì)胞浸潤及新生血管形成明顯多于對照組,且皮瓣內(nèi)血管管腔排列較整齊,對照組可見組織水腫較明顯,新生血管數(shù)量少,管腔不規(guī)則。術(shù)后3d和7d實驗組皮瓣MVD值(條/mm2)分別為(85.54±6.12)、(44.32±3.56),均高于對照組(49.35±4.75)、(18.75±2.89),差異有顯著統(tǒng)計學(xué)意義(P0.01)。術(shù)后7d實驗組皮瓣中VEGF和MMP-9蛋白含量明顯高于對照組。結(jié)論:低劑量X射線照射能夠促進(jìn)缺血皮瓣成活,其可能機制為低劑量X射線照射能夠增加缺血皮瓣中VEGF和MMP-9的表達(dá),從而促進(jìn)皮瓣內(nèi)血管新生。
[Abstract]:Objective: to investigate the effect of low dose X-ray irradiation (Low-Dose Irradiation,LDI) on the survival of ischemic flap and its possible mechanism. Methods: from June 2014 to December 2014, 80 SD rats were randomly divided into two groups, 40 rats in each group: experimental group A and control group B. A caudal ischemic random flap with a length and width of 9 cm 脳 3 cm was lifted retrograde on the back of the rat. The disinfected biofilm was placed under the flap to block the blood supply between the myometrium and the flap. Then the flap in group A was sutured in situ. The flap was given single local irradiation with a total dose of 0. 2 Gy immediately after operation. Group B was not irradiated after operation. From 1 to 14 days after operation, the two groups of flaps were observed, the tissue HE staining and Western-Blot detection were performed to calculate the survival rate, microvascular regeneration and the contents of VEGF and MMP-9 in the flaps. Results: the survival rates of flaps in experimental group were (66.46 鹵4.37), (44.30 鹵3.86), (32.20 鹵4.22), higher than those in control group (43.15 鹵5.03), (27.71 鹵3.20), (16.40 鹵5.34), respectively. The difference was statistically significant (P0.01) .HE staining showed that fibroblast infiltration and neovascularization were more common in experimental group than in control group. The vascular lumen of the flap was arranged neatly. In the control group, the tissue edema was obvious, the number of neovascularization was less, and the lumen was irregular. On the 3rd and 7th day after operation, the MVD of the flap in the experimental group was (85.54 鹵6.12), (鹵4.32 鹵3.56), which was higher than that in the control group (49.35 鹵4.75), (18.75 鹵2.89), and the difference was statistically significant (P0.01). The contents of VEGF and MMP-9 protein in the flaps in the experimental group were significantly higher than those in the control group 7 days after operation. Conclusion: low dose X-ray irradiation can promote the survival of ischemic skin flap, and the mechanism may be that low dose X-ray irradiation can increase the expression of VEGF and MMP-9 in ischemic flap and thus promote the angiogenesis of ischemic flap.
【學(xué)位授予單位】：蘇州大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R622

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