透明质酸酶、喜辽妥软膏治疗多西紫杉醇外渗性大鼠皮肤损伤

Comparison of the efficacy of intralesional hyaluronidase,topical hirudoid,and intralesional hyaluronidase plus topical hirudoid in the treatment of tissue damage caused by docetaxel extravasation in rats

目的:探讨单用或联合局部注射透明质酸酶、外涂喜辽妥软膏对多西紫杉醇外渗致大鼠损伤的防治效果。方法:将30只SD大鼠双侧侧腹部制作成多西紫杉醇血管外渗模型后随机分为6组:局部注射透明质酸酶,外涂喜辽妥软膏,局部注射透明质酸酶+外涂喜辽妥软膏,外涂生理盐水,局部注射生理盐水,模型对照组不进行任何防治措施。观察各组大鼠外渗性损伤发生率、损伤程度(损伤面积的AUC)、损伤愈合时间。结果:单用透明质酸酶组的损伤发生率显著低于外涂喜辽妥软膏组、外涂生理盐水组、局部注射生理盐水组、模型对照组(P<0.05),其损伤面积AUC和损伤愈合时间显著低于其他4组(P<0.01);单用喜辽妥软膏外涂的损伤发生率与生理盐水外涂组、模型对照组无显著性差异,其损伤面积AUC和损伤愈合时间显著低于生理盐水外涂组、模型对照组(P<0.01);透明质酸酶+外涂喜辽妥软膏组的损伤面积AUC和损伤愈合时间大于单用透明质酸酶组,但差异均无统计学意义。结论:单用透明质酸酶局部注射、喜辽妥软膏外涂对多西紫杉醇外渗性损伤均具有一定的防治效果,单药透明质酸酶局部注射疗效最佳,联合用药未能提高疗效。

Objective：The purpose of this study was to compare the efficacy of intralesional hyaluronidase,topical hirudoid, and intralesional hyaluronidase plus topical hirudoid in the treatment of tissue damage caused by docetaxel extravasation in a rat model. Methods：After establishing an animal model which was injected with 0. 6mg docetaxel into subcutaneous in each lateral belly of 30 Sprague-Dawley rats, the rats were randomly divided into six groups ：intralesional hyaluronidase, topical hirudoid, intralesional hyaluronidase plus topical hirudoid, topical saline, intralesional saline, and control group. The incidence rate and the wound AUC as well as the duration of wound were observed and compared. Results ：The incidence rate of tissue damage was significantly lower in intralesional hyaluronidase group than in topical hirudoid group, topical saline group, intralesional saline group, and control group （ P 〈 0. 05 ）. The AUC and the duration of wound were significantly lower in intralesional hyaluronidase group than in topical hirudoid group, topical saline group,intralesional saline group, and control group （P 〈 0. 01 ）. No significant difference about the incident rate of tissue damage was found between topical hirudoid group and topical saline group or control group. The AUC and the duration of wound were significantly lower in topical hirudoid group than in topical saline group, and control group （ P 〈 0. 01 ）. No significant difference about the incident rate of tissue damage was found between topical hirudoid group and topical saline group or control group. The incidence rate of tissue damage,the AUC and the duration of wound were higher in intralesional hyaluronidase plus topical hirudoid group than in intralesional hyaluronidase group. No significant difference was found between the two group （ P 〉 0.05 ）. Conclusion ： The monotherapy with intralesional hyaluronidase or topical hirudoid is effective therapy on tissue damage of rat caused by docetaxel extravasation. The efficacy of intralesional hyaluronidase plus topical chitosan seems not better than that of monotherapy with intralesional hyaluronidase.