骨折局部引流液纤粘素改变与愈合关系的实验研究

本实验用犬10条,检测了股骨骨折后1～7天局部引流液和血浆纤粘素(FN)的变化。发现骨折后24 h至7天,引流液内FN逐日增加。与骨折后24 h相比,48 h增加0.79倍(p<0.01);7 2h增加1.76倍(p<0.01),5天增加3.07倍(p<0.001);7天增加4.82倍(p<0.001);并含有FN的降解片段。骨折后6～72h,血浆FN有不同程度降低。 本文首次报道了骨折后局部引流液FN的变化规律,并发现骨折后引流液内FN的增加与愈合密切相关(r=0.0086;p<0.001)。根据本研究结果和目前报道的文献,本文提出如下设想:创伤局部细胞外环境中FN的增加和细胞表面FN的丧失是启动、控制和调节组织修复的重要因素。

EXPERIMENTAL STUDY ON RELATIONSHIP BETWEEN CHANGES OF FIBRONECTIN IN WOUND FLUID AND WOUND HEALING

The present study has been carried out in 10 dogs, in which fibronectin in wound fluid and plasma was measured with single radial immunodiffusion. Fibronectin in wound fluid rose from 24 hours to 7 days after fracture.The mean increase of fibronectin level was 0.79 (p<0.01),1.76 (p<0.01), 3.07 (p<0.001) and 4.82 (p<0.001) fold at 48, 72 hours, 5 and 7 days respectively as comparison with 24 hours after fracture.There were fibronectin degraded fragments in wound fluid.Plasma fibronectin levels were markedly reduced 6 to 72 hours after fracture. The mean decline was 19.2%(p <0.01), 18.0% (p<0.01), 28.0% (p<0.01) and 9.2%(p>0.05)at 6, 24, 48 and 72 hours, respectively.To our knowledge, there has been no report on the regularity of the changes of fibronectin in wound fluid before, and a close correlation(r= 0.9986,p<0.001) between the increase of fibronectin levels and wound healing.A hypothesis, based on our study and current literature, is presented that the increase of fibronectin in extracellular environment and the loss on cellular surface initiate, control and regulate the main biologic process of wound healing.