负压封闭引流对兔皮肤创面炎症细胞趋化和炎症因子分泌的影响

Effects of vacuum sealing drainage on chemotaxis of inflammatory cells and secretion of inflammatory cytokines in skin wound of rabbits

目的观察负压封闭引流(VSD)对兔创面炎症细胞趋化和炎症因子分泌的影响。方法建立兔皮肤创面模型,将建模后的12只实验兔随机分为常规组(n=6,创面消毒后不作特殊处理,仅每日常规换药、包扎)及VSD组[n=6,创面常规消毒,贴膜后给予持续-125mmHg(-16.6kPa)负压吸引]。分别于不同时间点在创缘处取材,经苏木素-伊红染色后光学显微镜观察并行巨噬细胞、中性多形核白细胞(PMN)和淋巴细胞计数,以酶联免疫吸附测定(ELISA)法检测创面组织肿瘤坏死因子-α(TNF-α)和白细胞介素-6(IL-6)含量。结果建模前VSD组与常规组比较,创面组织巨噬细胞、PMN及淋巴细胞计数无显著性差异(P>0.05)。建模后两组创面巨噬细胞和PMN计数均升高,与常规组比较,VSD组创面巨噬细胞计数显著增加(P<0.05),而其PMN及淋巴细胞计数则明显降低(P<0.01)。建模后两组创面TNF-α、IL-6含量均升高,二者均于24h时间点达到峰值后下降,VSD组创面TNF-α及IL-6含量显著低于常规组(P<0.05)。结论 VSD可通过调节巨噬细胞、PMN、淋巴细胞趋化以及细胞TNF-α、IL-6分泌而降低炎症反应并使其局限化。

Objective To observe the effects of vacuum sealing drainage（VSD） on inflammatory cells chemotaxis and inflammatory cytokines secretion in wound tissue of rabbits.Methods 12 rabbit skin wound models were established and randomly divided into conventional group（n=6,disinfecting without special treatment,only routine dressing and bandage daily） and VSD group[n=6,disinfecting routinely and continuous suction of-125 mmHg（-16.6 kPa） after membrane affixed to the wound].Wound tissue were collected at different time points and subjected to observation under optical microscopy after hematoxylin-eosin staining.Counting of macrophages,polymorphonuclear neutrophils（PMN） and lymphocyte were performed.Enzyme-linked immunosorbent assay（ELISA） was adopted to detect the contents of tumor necrosis factor-α（TNF-α） and interleukin-6（IL-6） in wound tissue.Results Compared with VSD group and conventional group before modeling,there were no significant differences in macrophages,PMN and lymphocyte counting in wound tissue（P0.05）.Amounts of macrophages and PMN in wound tissue in two groups were both increased after modeling.Compared to conventional group,the amount of macrophages in wound tissue in VSD group was markedly increased（P0.05）,while those of PMN and lymphocytes were obviously decreased（P0.01）.Contents of TNF-α and IL-6 in wound tissue in two groups were both increased after modeling and declined after achieving the peak value at the time point of 12 h.Contents of TNF-α and IL-6 in wound tissue in VSD group were notably lower than those of conventional group（P0.05）.Conclusion VSD reduces and localizes the inflammatory response through regulation chemotaxis of macrophages,PMN and lymphocytes as well as secretion of cellular TNF-α and IL-6.