还原型谷胱甘肽对大鼠随意皮瓣成活影响的实验研究

目的通过经大鼠腹腔注射还原型谷胱甘肽(glutathione,GSH),观察其对大鼠随意皮瓣成活的影响,并初步探讨GSH影响皮瓣成活的作用机制。方法选择健康200~250gSD大鼠20只,于背部双侧肩胛下角连线设计制备面积为8cm×2cm随意皮瓣,原位回植。随机分成两组(n=10),实验组于皮瓣术后即刻及1、2d,腹腔注射GSH(250mg/kg),对照组腹腔注射等量生理盐水。术后7d测定皮瓣成活率,取大鼠皮瓣中轴距蒂部3cm处组织,检测超氧化物歧化酶(superoxide dismutase,SOD)和丙二醛(malonyldialdehyde,MDA)含量,对皮瓣远、中及近段进行组织学观察。结果术后7d,实验组皮瓣成活率为56.77%±10.67%,高于对照组的40.16%±7.12%,差异有统计学意义(P<0.05)。实验组SOD含量为306.06±84.87U/mgprot,高于对照组的224.79±27.12U/mgprot;而MDA含量为3.835±0.457nmol/mgprot,低于对照组的6.127±0.837nmol/mgprot,差异均有统计学意义(P<0.05)。组织学观察:实验组近、中及远段中性粒细胞浸润较对照组明显减轻,其血管、成纤维细胞、毛囊及附属腺体增生均明显优于对照组。结论腹腔注射GSH对大鼠随意皮瓣成活有明显促进作用,作用机制可能与清除自由基、降低脂质过氧化反应及减轻中性粒细胞浸润有关。

EXPERIMENTAL STUDY ON EFFECT OF REDUCED GLUTATHIONE ON RANDOM FLAP SURVIVAL IN RATS

OBJECTIVE: To investigate the effects of glutathione (GSH) on survival of the random skin flap in rats and the probable mechanism that contribute to this effect. METHODS: Twenty SD rats with 200-250 g in weight, were randomly divided into the experimental group and control group(n = 10). Random flap of 8 cm x 2 cm in size was made on the back of each rat with the pedicel on the angular of the scapular. GSH (250 mg/kg) and NS of the same dose were injected into the abdominal cavity of rats in the experimental group and the control group immediately after the operative, 1st and 2nd days respectively. The rats were killed on the 7th day after the operation. The tissue pathology, the survival rate of the flap, the superoxide dismutase (SOD) activity and malonyldialdehyde (MDA) level were compared between two groups. RESULTS: The mean survival rate of the flap on the 7th day in the experimental group (56.77% +/- 10.67%) was higher than that in the control group (40.16% +/- 7.12%) (P < 0.05). SOD activity in experimental group (306.06 +/- 84.87 U/mgprot) was higher than that in the control group (224.79 +/- 27.12 U/mgprot), while MDA level (3.835 +/- 0.457 nmol/mgprot) was lower than that in the control group (6. 127+0. 837 nmol/mgprot) (P < 0.05). Histological observation showed that the neutrophil infiltration was less in experimental group than that in the control group; that the experimental group was surperior to the control group in angiogenesis, fibroblasts, fair cells and cuaneous gland. CONCLUSION: The intraperitoneal use of GSH may promote the survival rate of the random flaps and the possible mechanism for improvement may lies in that the GSH can reduce the level of oxygen free radical and lipidperoxidation, and lessen neutrophil infiltration.