N-乙酰半胱氨酸对大鼠背部随意型皮瓣活力影响的实验研究

Investigation of the Influence of N-acetylcysteine on the Viability of Random Pattern Skin Flaps

目的:观察抗氧化剂N乙酰半胱氨酸(Nacetylcysteine,NAC)对随意型皮瓣成活的影响。方法:采用Wistar大白鼠为实验动物,在其背部形成7cm×2cm的任意型皮瓣,将实验动物随机分为两组:对照组术后即刻腹膜下注射生理盐水,实验组术后即刻腹膜下注射NAC,并分别于术后1,12,24和48h取皮瓣组织作形态学观察并采用免疫组织化学方法(SP法)检测术后3h皮瓣组织TNFα的表达。结果:实验组皮瓣成活率明显高于对照组(P<0.01);组织学检查发现实验组皮瓣组织结构的破坏较对照组轻,炎症细胞浸润情况,术后1h两组差异无显著性意义(P>0.05),术后12,24和48h炎症细胞计数实验组低于对照组,两组差异有显著性意义(分别为P<0.05,P<0.01和P<0.01);两组术后3h皮瓣组织浸润的炎症细胞中均有TNFα表达,实验组为弱阳性,而对照组为强阳性。结论:腹膜下注射NAC可以提高大鼠背部随意型皮瓣成活率,其机制可能与下调TNFα等细胞因子的表达从而减少炎症细胞在皮瓣组织的浸润有关。

Objective: To investigate the influence of N-acetylcysteine(NAC) on the viability of random pattern skin flaps. Methods : A random pattern skin flap (7 cm×2 cm) was designed and elevated on the back of a Wistar rat. An image analysis technology was used to evaluate the survival rate of the skin flap, the optical microscope was used to detect the neutrophil counts in the tissue, and a immunohistochemical method was used to test the expression of tumor necrosis factor-α(TNF-α) in the inflammatory cells. Results: The survival rate of the flaps in the NAC group( 71.867±14.401)% was significantly enlarged (P<0.01) at the 7th day postoperatively, compared with that of the control group (52.484±16.420)%. The neutrophil counts in the NAC group were decreased significantly when compared with those in the control group at the 12th (P< 0.05), 24th (P<0.01) and 48th (P<0.01) hour after the operation. The immunohistochemical reaction of TNF-α was stronger in the control group. Conclusion: NAC as one kind of antioxidant can protect the skin flap tissues from destructive oxidation.