随意皮瓣术后内皮素变化及其受体阻滞剂对皮瓣微循环的影响

目的:探讨随意皮瓣术后内皮素(ET)水平变化及内皮素受体阻滞剂BQ-123(A选择性)对随意皮瓣微循环的影响.方法:SD大鼠背部肉膜下形成随意皮瓣,测皮瓣组织ET的变化趋势.分用药组(BQ-123组)和对照组(生理盐水组),测皮瓣存活率,取材进行HE染色光镜检查,使用激光多谱勒血流仪测量皮瓣血运情况.结果:皮瓣术后ET水平急剧上升,24 h内维持较高水平.术后第10天,用药组皮瓣的存活率显著高于对照组.HE染色光镜检查见用药组组织损害较对照组小.激光多谱勒测量发现用药组较对照组激光多谱勒血流量相对值(LDF)下降少,恢复快.结论:皮瓣术后ET水平急剧上升,并维持较高水平,内皮素受体阻滞剂BQ-123(ETA高度选择性)可以阻断ET作用途径,有利于改善皮瓣微循环.

Changes of ET after random-pattern skin flap operation and effects of BQ-123 (a kind of ETA recentor antagonists) on the microcirculation of the flap

Objective:To investigate the postoperative ET level and the effect of BQ-123(ETA receptor-specific antagonist) on microcirculatory of randompattem skin flaps of rats. Methods: ET levels were measured in 10 rats after operation at some points. Another 40 rats were divided randomly into 2 groups. One group were injected with BQ-123, the control received an injection of drug-free saline. Surviving portion of the flap was measured and the tissue was observed under light microscope. Using Doppler, the blood flow was measured.Results:The flap survival area injected with BQ-123 was significantly greater (p <0.01) than the control. Under light micro scope ,the change of the tissue in BQ-123 groups was less than the that of control. Using doppler ,in every point (except 10 th day postoperatively and preoperation) ,the blood flow in BQ-123 group was significiently higher than that of the control group( P < 0.01).After operation,ET increased quickly and kept in a high level. Conclusion: After operation ET level increases quickly and keeps in a high level. BQ-123(a kind of ETA receptor-specific antagonist) can significantly promotes survival of the skin flap.