小剂量胰岛素局部应用对移植无细胞真皮后血管化过程的影响

目的:观察小剂量胰岛素局部应用对无细胞真皮移植后血管化过程的影响。方法:制备猪脱细胞真皮基质。96只大鼠移植猪脱细胞真皮基质并浸润注射不同浓度胰岛素,A组0.1u、B组0.05u、C组0.01u组,D组注射等渗盐水。隔日注射,至术后第13d止。于移植后2,3,4,7,14,28d取无细胞真皮组织活检,HE及免疫组织化学染色观察移植物血管化过程,并测定血糖浓度的变化。结果:术后第2d在A、B组移植片双面浅层可见成纤维细胞及炎性细胞浸润;第4dA、B组移植片内血管内皮细胞数多于C、D组(P<0.05);第7dA、B组移植片双面浅层可见新生血管形成,结构完整;第14dA、B组血管数量明显大于C、D组(P<0.05);第28d各组间血管数无明显差异。B、C、D组注射胰岛素后6h血糖波动在4.80～7.70mmol/L,与术前相比无显著性差异,A组注射胰岛素后1h血糖明显降低(P<0.01)。结论:小剂量胰岛素局部应用能明显促进无细胞真皮的早期血管化过程。

Effect of topical application of low-dose insulin on revascularization process in acellular dermal matrix graft

Objective: To investigate the effect of topical application of low-dose insulin on revascularization process in acellular dermal matrix graft. Methods: Swine acellular dermal matrix (sADM) was prepared. Ninety-six rats were randomly divided into groups A,B,C,and D,in which the rats were injected with 0.1,0.05,and 0.01 u insulin and normal saline every other day until 13 days after sADM graft,respectively. The sADM was sampled on days 2,3,4,7,14,and 28 after grafting,and the revascularization process was observed after HE and immunohistochemical staining. The level of blood glucose was detected. Results: In groups A and B,fibroblasts and inflammatory cell infiltration were found in both superficial layers of graft on day 2. The vascular endothelial cells in groups A and B were significantly more than those in groups C and D on day 4 (P < 0.05). On day 7,neovascularization were detected in both superficial layers of the graft. The number of vessels in groups A and B was significantly more than that in groups C and D on day 14 (P < 0.05),and no significant difference was found in the number of vessels among 4 groups on day 28. The level of blood glucose in groups B,C,and D changed from 4.80 to 7.70 mmol/L 6 hours after the injection of insulin,and in group A it significantly decreased 1 hour after the injection (P < 0.01). Conclusion: Local injection of low-dose insulin could obviously promote early revascularization in acellular dermal matrix.