复制缺陷型腺病毒载体介导人血管内皮细胞生长因子cDNA促进静脉分叶皮瓣的成活

Replication-defective adenovirus vector-mediated human vascular endothelial cell growth factor cDNA promotes survival of lobulated venous flap

背景:静脉分叶皮瓣可修复多个手指皮肤软组织缺损,但静脉皮瓣普遍存在成活率不稳定,限制了其在临床上的应用。目的:观察以复制缺陷型腺病毒介导血管内皮细胞生长因子165基因(cDNA)局部应用对兔静脉分叶皮瓣成活的影响。方法:用新西兰大白兔制作侧腹壁双蒂轴型静脉分叶皮瓣,分别皮下注射介导血管内皮细胞生长因子165基因(Ad-VEGF)的复制缺陷型腺病毒、携带β半乳糖苷酶基因的腺病毒(Ad-Gal)和生理盐水。术后7d对3组兔进行皮瓣存活率、免疫组织化学、新生血管计数和常规组织切片的检测。结果与结论:术后7d,Ad-VEGF165组皮瓣成活率和平均血管数目显著高于Ad-Gal组和生理盐水组(P<0.01),皮瓣中血管内皮细胞及毛囊旁细胞中有大量VEGF蛋白阳性表达细胞,皮瓣中出现肉芽组织增生,新生血管大量形成。结果证实,以复制缺陷型腺病毒为载体介导的人VEGFcDNA能促进新生血管的形成并提高静脉分叶皮瓣的成活率。

BACKGROUND： Lobulated venous flap has some unique advantages to repair the soft tissue defects in many fingers. However, the poor viability of venous flaps limits their clinical applications. OBJECTIVE：To explore the effects of replication-defective adenovirus vector-mediated human vascular endothelial cell growth factor （VEGF） gene on survival of lobulated venous flap. METHODS：24 rabbits were randomly divided into three groups. Lateral abdominal wall skin flap was created in rabbits. At 5 days before operation, Ad-VEGF165 （Ad-VEGF165 group）, Ad-Gal （Ad-Gal group） and normal saline （NS group） were subcutaneously injected in the skin flap. The survival rate of the flap and the number of the new blood vessels were determined on the 7th day after operation. RESULTS AND CONCLUSION：The flap survival rate was （76.281±2.298）%, （50.408±1.577）% and （48.748±2.130）% in the Ad-VEGF165, Ad-Gal and NS groups, respectively. The number of the new blood vessels was （37.76±2.21） cm2, （22.68±2.15） cm2, and （23.31±3.38）/cm2 in the above-mentioned three groups, respectively. Immunohistochemical staining showed that lots of VEGF was expressed in the Ad-VEGF165 group. Blood vessel hyperplasia was obvious in the Ad-VEGF165 group. The replication-defective adenovirus vector-mediated VEGF gene can increase the neovascularization in lobulated venous flap and augments their survival rate.