当归多糖对皮瓣缺血再灌注损伤大鼠血液流变学影响的实验研究

Effect of angelica polysaccharides on the hemorheology in flap ischemia reperfusion injury： an experimental study in rats

目的研究当归多糖（angelicapolysaccharides，APS）对大鼠皮瓣缺血再灌注损伤后血液流变学指标的影响以及对损伤的保护作用。方法取50只sD大鼠随机分为五组：假处理组、对照组、2mg／ksAPS组、4ms／ksAPS组和8mg／kgAPS组。制取5cm×4cm腹部岛状皮瓣后，假处理组不作缺血．再灌注处理而直接原位缝合，对照组和各APS组缺血6小时后再灌注。各APS组于再灌注前5min腹腔注射相应剂量APS0．2ml，对照组则注射生理盐水0．2ml。于再灌注12h后测定三组大鼠皮瓣组织丙二醛（malondialdehyde，MDA）和超氧化物歧化酶（supemxidedismutase，SOD）水平、计数外周血中性粒细胞并用流式细胞术测定其表面CDlla／CDl8和CDllb／CDl8表达水平、检测外周血血液流变学各指标。结果再灌注12h后，8mg／kgAPS组与对照组相比，皮瓣MDA含量和CDlla／CDl8、CDllb／CDl8表达明显下降（P〈0．05），SOD水平显著升高（P〈0．05）；各APS组外周血中性粒细胞数量，全血低切粘度、中切粘度和高切粘度均明显低于对照组（P〈0．05）；各APS组较对照组血浆粘度、红细胞聚集指数差异无统计学意义（P〉0．05）。结论APS通过减少中性粒细胞数量，下调中性粒细胞表面的CDlla／CDl8和CDllb／CDl8表达，降低全血粘度来减轻大鼠皮瓣缺血再灌注损伤。

Objective To investigate the hemorheology changes in flap ischemia reperfusion injury and the protective effect of angelica polysaccharides （APS）. Methods Fifty adult SD rats were divided into a sham group, a control group, a 2 mg/kg APS group, a 4 mg/kg APS group, and a 8 mg/kg APS group. After a 5 cm × 4 cm epigastric flap was elevated, flaps in the sham group were sutured back into its place without inducing any ischemia. Flaps in the control group and APS treatment groups were subject to a 6-hour ischemic period. Five minutes prior to the reperfusion, 0.2 ml saline was injected via intraperitoneal route in the control group, while 0.2 ml of corresponding doses of angelica polysaccharides were injected in the APS groups. Following a 12-hour reperfusion, the levels of malondialdehyde （MDA） and superoxide dismutase （SOD） in the flap tissue were measured. Polymorphonuclear neutrophils （PMN） in the peripheral blood were counted. Flow cytometry was used to detect the expression of CDlla/CD18 and CDllb/CD18 on the polymorphonuclear neutrophils. Hemorheology parameters were detected in the rats of each group. Results Compared with the control group, 8 mg/kg APS group showed significant decrease of MDA content and CDlla/CD18, CDllb/CD18 expression levels after 12-hour reperfusion （ P 〈 0.05）. The level of SOD increased significantly （ P 〈 O. 05）. The PMN number, the low shear viscosity, the middle shear viscosity and high shear viscosity of the APS groups were significantly lower than those of the control group （ P 〈 O. 05）. Plasma viscosity, RBC aggregation index of the APS groups were not significantly different from the control group （ P 〉 0.05）. Conclusion APS can reduce ischemia reperfusion injury of skin flaps in rats via reducing the number of neutrophils, down-regulating the expression of CDlla/CD18 and CDllb/CD18 on neutrophil surface, and decreasing blood viscosity, so as to improve blood supply of the flap.