颌面部爆炸伤愈合过程中血管相关生长因子变化和作用的实验研究

A study of change and effect of angiogenic growth factors during maxillofacial blast wound healing

目的 探讨颌面部软组织爆炸伤愈合过程中血管内皮细胞生长因子（ＶＥＧＦ） 和碱性成纤维细胞生长因子（ｂＦＧＦ）在伤口液中含量的动态变化及其对创伤愈合中血管再生过程的刺激作用。 方法 采用改进的家兔颌面部爆炸伤动物模型，以ＫＴＹ－ ０４ 型雷管为爆炸源，复制颌面部爆炸损伤，选用聚乙烯醇（ＰＶＡ）海绵收集伤口液，双抗体夹心酶（ＥＬＩＳＡ） 法检测ＶＥＧＦ和ｂＦＧＦ含量。 结果 ＶＥＧＦ含量在伤后第１ 周内稳步上升，伤后１～２ ｄ 与正常血清组比较，差异显著（ Ｐ＜０ ．０５），３ ｄ 达（２．９±２．７） μｇＬ，差异非常显著（ Ｐ＜０．０１） ，７ ｄ 达峰值。ｂＦＧＦ含量伤后６ ｈ 即达峰值［（５６５±４３６） ｎｇＬ］，之后迅速下降，于伤后３～５ ｄ 基本恢复正常血清水平，伤后７ ｄ 略有上升。 结论 ＶＥＧＦ和ｂＦＧＦ参与颌面部爆炸伤愈合过程中血管再生的两个不同阶段，二者有协同作用，ｂＦＧＦ刺激启动血管再生，并诱导ＶＥＧＦ的合成，ＶＥＧＦ则调节和维持血管的再生过程。

Objective To determine the content change of vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF) in the wound fluid and their effect on angiogenesis in the wound healing during healing of maxillofacial soft tissue blast injury. Methods The improved rabbit model of maxillofacial blast injury was made by KTY 04 blasting cap. The contents of VEGF and bFGF in the wound fluid were detected by enzyme linked immunosorbent assay (ELISA). Such fluid was collected by Polyvinyl alcohol (PVA) sponge. Results In the wound fluid of maxillofacial blast injury, the content of VEGF was rising steadily in the first week after injury. Compared with natural sera, it showed difference from the first day after injury, obvious difference from the third day ( P <0.01) when the content was (2.9±2.7) μg/L. The peak appeared at the seventh day. The bFGF in wound fluid reached the peak value (565±436) ng/L, 6 hours later. Then, it declined near to natural serum level 3 5 days after injury, and then moved up slightly seven days later. Conclusions VEGF and bFGF took part in two angiogenic phases with synergistic action in maxillofacial blast injury. The bFGF stimulated the initial angiogenesis and induced production of VEGF. VEGF regulated and maintained vascular regeneration.