局部应用VEGF对失神经皮瓣抗菌力影响的实验研究

Experimental study on effect of local application of vascular endothelial growth factor on antibacterial power of denervated skin flap

目的观察血管内皮生长因子(VEGF)在失神经皮瓣中对白细胞功能的影响,探讨VEGF在皮瓣抗感染中的作用机理。方法选用60只Wister大鼠,制作右下腹2cm×2cm岛状皮瓣的动物模型,随机分为3组。所有皮瓣接种金黄色葡萄球菌悬液(5×107/mL)2mL,动物观察96h后处死。测定白细胞计数、白细胞活力、中性粒细胞化学发光、组织细菌计数、皮瓣组织肉眼观察及光镜观察等指标。结果术后96h三组渗出液中白细胞计数比较差异无统计学意义(P>0.05);而在白细胞活力、中性粒细胞化学发光、组织细菌计数等指标测定中,慢性失神经组较对照组差异有统计学意义(P<0.01);VEGF治疗组较慢性失神经组差异有统计学意义(P<0.01)。皮瓣组织病理变化:对照组及VEGF治疗组皮瓣的病理改变较轻。结论软组织失去神经支配后,降低了白细胞的功能。而血管内皮生长因子能改善皮瓣微循环,并有增强白细胞功能的作用。

Objective To investigate the effect of vascular endothelial growth factor （VEGF） on the leukocyle function in a rat denervated infect flap model and to investigate the action mechanison of VEGF in the flap anti-infection .Methods An island pedicle flap measured 2 cm × 2 cm was raised on the right abdomen of sixty wister rats ,which were divided into three groups .All flaps re-ceived intradermal inoculation of 107 Staphylococcus aureus ,and the animals were observed for 96 h .The indexes of the leukocyte count ,leukocyte vitality ,hemiluminescence of neutrophils ,tissue bacterial count ,naked eyes observation of falptissue and the light microscope observation were detected .Results The leukocyte count in the exudation at postoperative 96 h had no statistical differ-ences among 3 groups（P〉0 .05）;while in the indexes detection of the leukocyte vitality ,chemiluminescence of neutrophils ,tissue bacterial count ,etc .,the comparison between the chronic denervated group and the control group showed very significantly differ-ences（P〈0 .01）;the differences between the VEGF treatment group and the chronic denervated group was very significant （P〈0 .01） .The falp pathological change in the control group and the VEGF treatment groups was slight .Conclusion The soft issue af-ter losing the innervation decreases the leukocyte function .VEGF might improve the flap micro circulation and play an important role in improving the leukocyte function .