辐射对伤口液调节成纤维细胞特性的影响和苯妥英钠的应用

INFLUENCE OF MODULATORY ACTIVITY OF WOUND FLUID ON THE CHARACTERISTICS OF FIBROBLASTS FROM IRRADIATION AND THE ACTION OF PHENYTOIN SODIUM

目的研究全身辐射后伤口液对成纤维细胞（ＦＢＳ）特性的调节作用的变化及苯妥英钠的作用。方法采用大鼠背部置入聚乙烯醇海绵的切口伤模型，收集伤口液和ＦＢＳ，并测定ＦＢＳ的增殖和胶原合成特性。结果在伤后５～８天，伤口液刺激ＦＢＳ增殖和胶原合成的作用最强，６Ｇｙ全身辐射后，伤口液刺激ＦＢＳ增殖和胶原合成的作用都明显降低，而苯妥英钠对非辐射组和辐射组伤口液刺激ＦＢＳ增殖和胶原合成的作用都有明显的提高。结论全身辐射后，伤口局部环境的改变不利于组织细胞的修复；苯妥英钠能加强伤口液刺激ＦＢＳ增殖和胶原合成的作用，有利于创伤愈合。

Objective Influence of irradiation and phenytoin sodium on modulatory activities of wound fluid on proliferation of fibroblasts and collagen synthesis was studied. Methods The male Wistar rats were used in this study. The rats were divided into irradiated and non irradiated groups, and in each of them it was subdivided into phenytoin group and control. A 7 cm long incisional wound was made on the back of each rat, in which a polyvinyl alcohol sponge (PVAS) with a size of 1.0 cm×0.4 cm was implanted into the wound and the wound was sutured up. The PVAS was prepared by rinsing in running water over night and then was boiled for 30 minutes. Before implantation, the sponge was immersed in phenytoin sodium solution (10 mg/1 ml) or normal saline (as control). From each wound the wound fluid and fibroblasts were collected. The methods of incorporation of 3 H were adopted to assess the proliferation of fibroblasts and synthesis of collagen. Results It was shown that proliferation of fibroblasts and collagen synthesis were stimulated by wound fluid remarkably on 5 to 8 days after wounding, and that 6 Gy to total body irradiation wound decrease this effect. It was also noted that topical phenytoin sodium increased the modulatory activity of wound fluid irrespective of being iradiated or not. Conclusion It could be drawn that, after total body irradiation, stimulation of hyperplasia of fibroblasts and collagen synthesis by wound fluid was markedly lowered indicating the total body irradiation resulted in changes of local conditions of the wound which was unbenefitted to repair of tissue cells, while phenytoin sodium could enhance the stimulating action of wound fluid on proliferation of fibroblasts and synthesis of collagen which was beneficial to wound healing.