不同剂量血管内皮细胞生长因子皮下局部注射对大鼠背部随意型皮瓣成活影响的实验性研究

The Effect of VEGF on Survival of a Random Flap in the RAT.

目的 :探讨皮下局部注射VEGF解决皮瓣远端缺血坏死的有效性和剂量依赖性。方法 :5 0只Wistar大鼠 ,随机分成五组 ,在其背部形成 2cm× 8cm的全厚随意型皮瓣。术后即刻给予如下处理 :对照组原位缝合 ;VEGFa组于皮瓣远蒂端 5～ 8cm处皮下注射 80ngVEGF ;VEGFb组于皮瓣相应部位皮下注射 12 0ngVEGF ;VEGFc组皮下注射16 0ngVEGF ;VEGFd组皮下注射 2 0 0ngVEGF ,给药完毕后 ,立即原位缝合。术后 5d将动物处死 ,计算皮瓣成活面积及成活百分比。结果 :术后第 5d皮瓣成活面积 (cm2 ) :对照组为 (10 .5 2± 1.14)、VEGFa组为 (10 .5 9± 2 .2 1)、VEGFb组为 (10 .5 6± 1.17)、VEGFc组为 (11.2 5± 2 .6 1)、VEGFd组为 (13.35± 1.46 ) ,VEGFa组与VEGFb组同对照组相比无显著性差异 (P >0 .0 5 ) ,VEGFc组同对照组相比有显著性差异 (P <0 .0 5 ) ,VEGFd组同对照组相比有显著性差异 (P <0 .0 1)。结论 :一次性局部注射足量的VEGF是解决皮瓣远端缺血坏死的行之有效的方法 ;并且可以大大地提高皮瓣的长宽比例 ;在有效剂量以上时 ,皮瓣的成活率与VEGF成明显的剂量依赖性关系 ;局部注射同系统给药相比较其优点在于所需要的剂量小 ,且效果显著。

Objective:The puruose of the present study was to determine the effects of vascular endothelial growth factor (VEGF) on survival of a full thickness random pattern,McFarlane musculocutaneous flap in the rat.In addition,this study examined the effects of different dose of VEGF on the flap viability.Methods:A 2×8cm full thickness dorsal flap with the pedicle remaining attached at the posterior end was elevated in 50 Wistar rats.The rats was randomised into three groups and received the following treatment:Group VEGFa(n=10):subdermal VEGF injection into the flap(80ng/400μl) after flap elavation;Group VEGFb (n=10): subdermal VEGF injection into the flap(120ng/600μl) after flap elavation;Group VEGFc (n=10): subdermal VEGF injection into the flap(160ng/800μl) after flap elavation. :Group VEGFd(n=10):subdermal VEGF injection into the flap(200ng/100μl) after flap elavation;Group control(n=10):without any treatment after flap elavation.Results:After five days recovery,the area of flap survival was measured. Mean flap survival in Group control was (10.52±1.12);Group VEGFa was (10.59±2.21),Group VEGFb was (10.56±1.17),Group VEGFc was(11.25±2.61),Group VEGFd was(13.35±1.46).There was significant difference between group VEGFc,VEGFd and the control groups (P<0.05,P<0.01).Conclusions:These results support the notion that VEGF rescues tissue at risk of hypoxic damage by inducing angiogenesis,and the use of growth factors such as VEGF holds promise as a method of increasing skin viability;VEGF can improve the ratio of the longth and width of the flaps ;above the effective dose ,with the dose increasing,the viable part of the flaps will improve;the advantage of the local injection is that the smaller dose can obtain the better effect.