缺血后处理对保护皮瓣作用机制研究.docVIP

缺血后处理对保护皮瓣作用机制研究 　　[摘要]目的：缺血后处理已经在心、肾等器官上广泛应用，进行相关研究进一步探究缺血后处理对皮瓣有否保护作用。方法：健康成年新西兰大白兔，分为3组。A组为给予缺血后处理；B组为再灌注前5min给予A2A阻滞剂 SCH58261+缺血后处理。C组，直接应用微血管夹阻断腹壁浅血管持续缺血6h后，恢复正常血供。分别进行中性粒细胞浸润，MPO含量和皮瓣存活率检测。结果：新西兰大白兔完全存活。B、C组相比较，中性粒细胞计数以及MPO含量也未见统计学差别（P0.005）。实验组皮瓣存活面积比较，B与C相比较，无统计学意义(P0.005），但是A与B、C相比较，上述指标两两之间都有统计学意义差别(P 　　[关键词]：皮瓣；缺血-再灌注损伤；A2A受体 　　[中图分类号]R622[文献标识码]A[文章编号]1008-6455（2011）03-0416-03 　　 　　Study of the mechanism on the ischemia postconditioning for the protection of the skin flap 　　LIN Huang,DONG Yong 　　(Department of Plastic Surgery, Anzhen Hospital,Capital University of Medical Science,Beijing 100029,China) 　　 　　Abstract:ObjectiveThe ischemia postconditioning is widely used for the protection of the heart, kidney, a further study is done to explore the protection of the ischemia postconditioning on the skin flap.MethodsThe adult newzlend rabbits are divided into 3 group.A group is provided with ischemia postconiditoning; B group is provided with A2A inhibitor SCH58261 plus ischemia postconditioning. C group is provided with direct ischemia with microvascular clamp.The study includes neutrophil cell infiltration,content of MPO and the survival of skin flap.ConclusionThe rabbits all survived .No difference existed between B and C group about neutrophil count and content of MPO（P0.005）.No difference was found about the skin flap survival. But about the above three parameters,A group was found to have significance between B and C group.ConclusionIschemia postconditioning can protect the skin flap which may be attributed to the role of the A2A receptor. 　　Key words:skin flap;ischemia-reperfusion injury;A2A receptor 　　 　　自2003年Zhao 等提出缺血后处理( ischemiapostconditioning) 的概念以来，缺血后处理提高组织对缺血的耐受性、减轻组织缺血再灌注损伤的作用已在全身的多个器官通过动物和临床的证据???实[1-3]。但是缺血后处理对皮瓣作用尚未经证实，进行相关研究探究缺血后处理对皮瓣的保护作用。 　　 　　1材料和方法 　　1.1 动物模型的建立：选用健康成年新西兰大白兔32只,雌雄不限,体重2.5～3.5kg。腹腔内注射异戊巴比妥钠麻醉，仰卧位固定于实验台上，腹部备皮，制备左侧腹股沟皮瓣约4cm×8cm，保留腹壁浅血管备用。 　　1.2 实验方法与分组：模型建立后,实验动物随机分为3组。对照组为C组，直接应用微血管夹阻断腹壁浅血管持续缺血6h后，恢