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目的 :探讨颌面部软组织爆炸伤愈合过程中血管内皮细胞生长因子 (VEGF)和碱性成纤维细胞生长因子(bFGF)的分布和在伤口液中含量的动态变化 ,及其对血管再生的刺激作用。方法 :采用改进的家兔颌面部爆炸伤动物模型 ,选用聚乙烯醇 (PVA)海绵收集伤口液 ,ELISA法和免疫组化、原位杂交法分别检测VEGF和bFGF的含量及分布。结果 :颌面部爆炸伤伤口液中VEGF含量在伤后第 1周内稳步上升 ,于伤后第 3天达到 2 9ng ml± 2 7ng ml,和对照组相比 ,差异非常显著 (P <0 0 1) ,伤后 7d达峰值。伤口液中bFGF的含量在伤后 6h即达到峰值 ,为5 6 5pg ml± 436pg ml,之后迅速下降。VEGF的表达位于上皮细胞、血管内皮细胞及部分慢性炎症细胞 ;bFGF的转录出现于血管内皮细胞和成纤维细胞 ,部分巨噬细胞中也有阳性表达。结论 :VEGF和bFGF参与颌面部爆炸伤愈合过程中血管再生的两个不同阶段 ,二者有协同作用 ,bFGF刺激血管再生的启动 ,并诱导VEGF的合成 ,VEGF则调节和维持之后的血管再生过程。
OBJECTIVE: To investigate the distribution of vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF) and their dynamic changes in wound fluid during the healing of maxillofacial soft-tissue explosive wounds and their effects on the stimulation of revascularization effect. Methods: An improved animal model of maxillofacial explosive injury in rabbits was established. Wound fluid was collected by PVA sponge, and the content and distribution of VEGF and bFGF were detected by ELISA, immunohistochemistry and in situ hybridization. Results: The content of VEGF in maxillofacial explosive wounds increased steadily in the first week after injury, reaching 29 ng ml ± 2 7 ng ml on the third day after injury, which was significantly different from the control group (P <0 0 1), reaching the peak on the 7th day after injury. The content of bFGF in the wound fluid peaked at 6 hours after injury, which was 565 pg ml ± 436 pg ml and then dropped rapidly. VEGF expression is located in epithelial cells, vascular endothelial cells and some chronic inflammatory cells; bFGF transcription in vascular endothelial cells and fibroblasts, some macrophages are also positive expression. CONCLUSION: VEGF and bFGF are involved in two different stages of angiogenesis during the healing of maxillofacial explosive wounds. Both of them have a synergistic effect. BFGF stimulates the initiation of angiogenesis and induces the synthesis of VEGF. VEGF regulates and sustains the subsequent revascularization process.