目的观察负压创面治疗技术对糖尿病大鼠创面血管生成的影响。方法取40只sD大鼠，按65mg／kg腹腔注射20g／L链脲佐菌素诱导糖尿病模型。2周后按随机数字表法将大鼠分为对照组和负压组，每组20只，在大鼠背部正中切除2cm×2cm全层皮肤制备创面。伤后即刻，对照组创面常规换药；负压组创面予以每天4h持续负压（-16．0kPa）治疗，连续7d。（1）治疗前及治疗后1、2周，分别采用血糖仪及电子秤检测2组大鼠血糖及体质量。（2）治疗前及治疗后1、3、7d，每组取5只大鼠，采用激光多普勒血流成像仪检测创面血流量。（3）治疗后3、7d，每组取5只大鼠处死后切取创面组织并分成两部分，取左侧组织行免疫组织化学染色观察血管形成情况，计算微血管密度。（4）取治疗前制备创面时切取的全层皮肤及治疗后3、7d冻存的右侧组织，治疗后1、14d同前切取创面组织，采用实时荧光定量PCR法检测组织中血管内皮生长因子（VEGF）、血管内皮生长因子受体1（Fit—1）、血管生成素1（Ang—1）、Ang-2以及酪氨酸激酶受体2（Tie-2）mRNA的表达。对数据行双因素方差分析或LSD—t检验。结果（1）2组大鼠血糖及体质量水平总体或各时相点比较无明显差异（F值分别为0．667、0．176，t值为0．311～0．707，P值均大于0．05）。（2）2组大鼠创面血流量总体比较有明显差异（F=24．66，P〈0．05）。治疗后1、3、7d，负压组创面血流量分别为（179±24）、（219±12）、（192±30）灌注单位，显著高于对照组的（127±16）、（179±8）、（144±17）灌注单位（t值分别为3．71、5．57、2．77，P〈0．05或P〈0．01）。（3）2组大鼠创面微血管密度总体比较有明最差异（F=33．25，P〈0．05）。治疗后3d，负压组创面每100倍视野下微血管密度为（80±12）个，明显高于对照组的（38±4）个（t=9．257，P〈0．05）。治疗后7d，2组大鼠创面微血管密度相近（t=1．159，P〉0．05），此时负压组血管排列规律、管腔宽畅，而对照组血管排列紊乱、管腔狭窄。（4）治疗后1、3d，负压组VEGF、Fit-1及Ang-1mRNA表达水平均明显高于对照组（t值为1．28-11．60，P值均小于0．01）；治疗后7d，负压组Ang-1mRNA表达水平（27．59±3．55）明显高于对照组（19．87±1．86，t=7．23，P〈0．001），其拮抗剂Ang-2mRNA表达水平（5．79±0．61）明显低于对照组（17．62±0．85，t=19．88，P〈0．001）。治疗后3～14d，负压组Tie-2mRNA表达水平均低于对照组（t值为8．92～15．60，P值均小于0．01）。结论负压创面治疗技术可能通过增强创面愈合后期Ang-1表达以及降低Ang-2表达，促进糖尿病大鼠创面血管形成。
负压创面治疗技术对糖尿病大鼠创面血管生成的影响
【摘 要】
：
目的观察负压创面治疗技术对糖尿病大鼠创面血管生成的影响。方法取40只sD大鼠，按65mg／kg腹腔注射20g／L链脲佐菌素诱导糖尿病模型。2周后按随机数字表法将大鼠分为对照组和负压组，每组20只，在大鼠背部正中切除2cm×2cm全层皮肤制备创面。伤后即刻，对照组创面常规换药；负压组创面予以每天4h持续负压（-16．0kPa）治疗，连续7d。（1）治疗前及治疗后1、2周，分别采用血糖仪及电子秤检测2
【机 构】
：
第四军医大学西京医院全军烧伤中心,烧伤与皮肤外科,西安710032,第四军医大学西京医院全军烧伤中心,烧伤与皮肤外科,西安710032,第四军医大学西京医院全军烧伤中心,烧伤与皮肤外科,西安71003
【发表日期】
：
2013年29期
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