芦荟凝胶对大鼠多柔比星外渗性损伤的影响

Effects of aloe gel on doxorubicin-induced extravasation injury in rats

背景与目的:芦荟对多种化疗药物外渗性损伤有良好的防护作用。本实验主要研究芦荟凝胶对大鼠多柔比星外渗性损伤的防治作用,初步探讨芦荟凝胶促进大鼠多柔比星外渗性损伤伤口愈合的机制。方法:建立SD大鼠多柔比星外渗性损伤动物模型,将30只SD大鼠采用自身对照法随机分组:对照组(生理盐水)、实验组(芦荟凝胶1g/L)和硫酸镁组(50%硫酸镁湿敷),测量各组大鼠外渗性损伤的面积,观察损伤程度;在治疗后第1、4、7、11、18天各组分别随机取2只大鼠,切除损伤组织,HE染色观察病理形态学改变。另取30只外渗性损伤模型大鼠随机分组,分组同上。于损伤后第5天切除外渗损伤部位的皮肤及皮下组织,间断缝合,术后第7天拆线,观察手术伤口Ⅰ期愈合情况和愈合时间。用免疫组化法检测损伤部位的皮肤及皮下组织中的血管内皮生长因子(vascular endothelial growth factor,VEGF)、表皮生长因子受体(epidermal growth factor receptor,EGFR)的表达情况。结果:芦荟凝胶组和硫酸镁组的外渗性损伤面积及程度明显低于生理盐水组(P<0.01)。对照组、芦荟凝胶组和硫酸镁组的手术伤口Ⅰ期愈合率分别为20.0%、60.0%和66.7%,伤口愈合时间分别为(12.1±2.1)d、(9.6±1.6)d和(9.3±1.4)d,对照组与另外两组之间的差异均有统计学意义(P<0.01)。免疫组化检测结果显示,芦荟凝胶组与生理盐水组比较,VEGF、EGFR的表达呈现上调。结论:芦荟凝胶对大鼠多柔比星外渗性损伤有良好的防治作用,其促进伤口愈合的机制可能与组织中VEGF、EGFR的表达上调有关。

Background and Objective： Aloe has preventive effects on some chemotherapy-induced extravasation injuries. This study was to investigate the effect and mechanism of aloe gel on doxorubicin-induced extravasation injury. Methods： Sprague-Dawley （SD） mice were used to establish the extravasation injury model induced by doxorubicin. Thirty SD mice were randomly divided into three groups： control group, aloe gel group （1 g/L） and 50% magnesium sulfate group. The area of extravasation was measured and the degree of injury was observed. The injured tissues were resected from two randomly selected rats in each group on the 1st, 4th, 7th, 11th, and 18th day after treatments. Pathological morphology of the resected tissues was observed under an optical microscope after hematoxylin and eosin （HE） staining. The exosmosis skin and subcutaneous tissues of rats were resected five days after treatments. Then the wounds were interruptedly sutured. When sutures were removed on the 7th day after operation, the condition of primary wound healing and the healing time were recorded. Expressions of vascular endothelial growth factor （VEGF） and epidermal growth factor receptor （EGFR） in the exosmosis skin and subcutaneous tissues were detected by immunohistochemistry. Results. The area and the degree of extravasation injury were smaller and less severe in the aloe gel and magnesium sulfate groups than in the control group （P〈0.01）. The rates of primary wound healing were significantly higher in the aloe gel （60.0%） and magnesium sulfate （66.7%） groups than in the control group （20.0%）; while the healing time was significantly shorter in the aloe gel （9.6±1.64 d） and magnesium sulfate （9.33±1.40 d） groups than in the control group （12.13±2.06 d） （both P〈0.01）. Moreover, the expression levels of VEGF and EGFR were higher in the aloe gel group than in the control group. Conclusion： The preventive and therapeutic effects of aloe gel on doxorubicin-induced extravasation injury are satisfactory, which may be in relation to the up-regulation of VEGF and EGFR.