低剂量X射线照射对缺血皮瓣成活影响的实验研究

发布时间：2018-09-02 08:52

【摘要】：目的:探讨低剂量X射线照射(Low-Dose Irradiation,LDI)对缺血皮瓣成活的影响及其可能的机制。方法:2014年6月至2014年12月,选取SD大鼠80只,将大鼠随机分为2组,每组40只,分别为实验组A、对照组B。于大鼠背部逆行掀起1个长宽为9 cm×3 cm的蒂部靠尾侧的缺血随意皮瓣,将经消毒处理的生物隔离膜垫于皮瓣下以阻断肌层与皮瓣的血供联系,然后原位间断缝合。A组皮瓣术后立即给予总剂量值为0.2 Gy的低剂量X射线单次局部照射,B组术后不予照射。术后1-14d分别对两组皮瓣行大体观察、组织HE染色和Western-Blot检测,计算皮瓣成活率、微血管新生情况以及皮瓣中VEGF和MMP-9的含量。结果:术后3d、7d以及14d实验组皮瓣成活率分别为(66.46±4.37)%、(44.30±3.86)%、(32.20±4.22)%,均高于对照组(43.15±5.03)%、(27.71±3.20)%、(16.40±5.34)%,差异有显著统计学意义(P0.01)。HE染色实验组皮瓣内可见成纤维细胞浸润及新生血管形成明显多于对照组,且皮瓣内血管管腔排列较整齐,对照组可见组织水肿较明显,新生血管数量少,管腔不规则。术后3d和7d实验组皮瓣MVD值(条/mm2)分别为(85.54±6.12)、(44.32±3.56),均高于对照组(49.35±4.75)、(18.75±2.89),差异有显著统计学意义(P0.01)。术后7d实验组皮瓣中VEGF和MMP-9蛋白含量明显高于对照组。结论:低剂量X射线照射能够促进缺血皮瓣成活,其可能机制为低剂量X射线照射能够增加缺血皮瓣中VEGF和MMP-9的表达,从而促进皮瓣内血管新生。
[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 卤4.37), (44.30 卤3.86), (32.20 卤4.22), higher than those in control group (43.15 卤5.03), (27.71 卤3.20), (16.40 卤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 卤6.12), (卤4.32 卤3.56), which was higher than that in the control group (49.35 卤4.75), (18.75 卤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.
【学位授予单位】：苏州大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R622

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