水胶体敷料防治静脉炎与细胞黏附分子1和血管内皮生长因子的表达

Effects of hydrocolloid dressings on cellular adhesion molecule-1 and vascular endothelial growth factor expressions in a rabbit model of phlebitis

背景:关于水胶体敷料防治由甘露醇引起静脉炎的方法报道较多,但大多均为临床疗效观察,缺乏微观证据支持。目的:拟以水胶体敷料防治兔静脉炎的实验,揭示与认识水胶体敷料防治静脉炎的作用机制。设计、时间及地点:前瞻性随机对照实验,于2005-01/2006-01在四川大学华西医院动物实验中心完成。材料:水胶体敷料选择康惠尔增强型透明贴,严格按照纳入、排除标准将16只基线资料一致的健康日本大耳白兔随机分成模型组和康惠尔组,每组8只。方法:采用20%甘露醇溶液静脉滴注,诱导实验性静脉炎。模型组每次输入甘露醇后不给予任何治疗措施;康惠尔组每次输液结束后5min之内给予康惠尔增强型透明贴贴敷至下次输液时取下。主要观察指标:于末次输液后24h取标本对各组兔耳缘静脉进行病理组织检查,检测模型组和康惠尔组兔耳缘静脉损伤时细胞内黏附分子1和血管内皮生长因子的表达量。结果:模型组和康惠尔组细胞内黏附分子1和血管内皮生长因子表达均有不同程度的增高,而康惠尔组细胞内黏附分子1、血管内皮生长因子表达低于模型组,差异有显著性意义(P<0.05)。结论:康惠尔增强型透明贴防治兔浅静脉炎的作用与其抑制血管损伤时细胞内黏附分子1和血管内皮生长因子的升高有关。

BACKGROUND： There are many methods for treating phlebitis caused by mannitol; however most of them are clinical observation studies, lack of mechanism study. OBJECTIVE： To explore the mechanism of hydrocolloid dressing in the prevention and treatment of rabbits with phlebitis. DESIGN, TIME AND SETTING： A prospective randomized controlled animal experiment was performed at the Animal Experimental Center, West China Hospital, Sichuan University from January 2005 to January 2006. MATERIALS： Hydrocolloid dressings of enhancement type were used in this study. A total of 16 healthy large-eared Japanese rabbits were randomly divided into model and hydrocolloid dressing groups, with 8 rabbits in each group. METHODS： The animal model of experimental phlbeitis was established by 20% mannitol infusion. Each group was given respective preventive measures five minutes after each transfusion. Any treatment was not given in the model group after mannitol infusion. However, hydrocolloid dressings were given in the hydrocolloid dressing group within 5 minutes after mannitol infusion. MAIN OUTCOME MEASURES： Pathohistological examination was performed on rabbit auricular vein in order to detect expressions of cellular adhesion molecule-1 and vascular endothelial growth factor at 24 hours after the last infusion. RESULTS： The expressions of cellular adhesion molecule-1 and vascular endothelial growth factor were increased in both groups to a certain degree; however, the expressions of cellular adhesion molecule-1 and vascular endothelial growth factor in the hydrocolloid dressing group were significantly less than model group （P 〈 0.05）. CONCLUSION： The effect of hydrocolloid dressings on prevention and treatment of phlebitis may relate to the increasing expressions of cellular adhesion molecule-1 and vascular endothelial growth factor during habiting vascular damage.