血管内皮细胞生长因子和碱性成纤维细胞生长因子加速预构扩张皮瓣成熟的研究

目的　观察以生物蛋白胶局部缓释血管内皮细胞生长因子 (VEGF)和碱性成纤维细胞生长因子(b FGF)应用于兔预构扩张皮瓣对细胞增殖及凋亡、血管化进程 ,以及皮瓣成熟的作用。　方法　将新西兰大耳白兔 5 3只随机分为正常、空白、生物蛋白胶、VEGF直接应用、VEGF胶及 b FGF胶共 6组 ,兔耳中央动静脉束植入预构扩张皮瓣 ,14天后形成 3cm× 5 cm岛状瓣。分别进行皮瓣成活面积、激光多普勒血流量、铅丹灌注、墨汁灌注、PCNA免疫组化和 TUNEL 凋亡检测。　结果　两种生长因子应用组皮瓣成活面积较其它组增加 ,血流灌注量增多 ,新生毛细血管密度加大 ,细胞增殖提高、凋亡减少。　结论　 VEGF和 b FGF均能通过刺激细胞增殖和减少凋亡发生来促进血管新生和预构扩张皮瓣成熟 ,用生物蛋白胶缓释生长因子有独特效果。

ACCELERATED MATURATION OF EXPANDED PREFABRICATED FLAPS BY USE OF VASCULAR ENDOTHELIAL GROWTH FACTOR AND BASIC FIBROBLAST GROWTH FACTOR IN RABBITS

Objective To evaluate the effect of vascular endothelial growth factor (VEGF)165 or basic fibro blast growth factor (bFGF), which was slowly released in fibrin glue patch, on expanded prefabricated flaps in rabbits to facilitate the neoangiogenesis process. Methods A total of 53 rabbits were divided randomly into 6 groups. The central auricular vascular bundle of the ear was implanted into the expanded prefabricated flap as the pedicle. Fibrin glue, sandwiched between the expander and the implanted vessels, was adopted for topical delivering and slow releasing of VEGF(625ng) or bFGF(2880U). After 14 days, the island flap with the implanted vascular bundles as the pedicle was elevated, sutured back to its original position and then harvested more 3 days later. Neoangiogenesis was measured by digital recording of survival area, laser Doppler flowmetry, PCNA immunohistochemistry, TUNEL, ink and PbO infusions. Results When compared with the other groups, flap survival improved; neoangiogenesis of flaps increased, together with the blood flow enhanced in the groups applied growth factors. The reduced cellular apoptosis and the increased proliferation were also observed. Conclusion VEGF or bFGF slowly released by fibrin glue shows the potential to facilitate neoangiogenesis and accelerate maturation of the expanded prefabricated flap.