乳癌根治术皮瓣存活与红细胞SOD及血浆LPO水平的关系

对３０例乳癌根治术患者术前、术毕及术后６、１２、２４、４８、７２小时各时相红细胞中的超氧化物歧化酶（ＳＯＤ）及血浆过氧化脂质（ＬＰＯ）的水平进行了测定。结果显示：乳癌患者红细胞ＳＯＤ含量与血浆ＬＰＯ水平呈显著负相关（ｒ＝－０．９０６４，ｔ检验Ｐ＜０．０１），术后血浆ＬＰＯ波动幅度及持续时间均大于红细胞ＳＯＤ；术毕皮瓣组织的ＳＯＤ下降，而ＬＰＯ上升，其差异显著（Ｐ＜０．０５）。推测其动态变化与血液中的变化相一致。此外，光镜见皮肤组织有嗜中性白细胞浸润，电镜观察显示皮肤微血管内皮损伤。作者认为，乳癌根治术后自由基产生增多导致微血管内膜损害是皮瓣坏死的重要原因。

RELATIONSHIP BETWEEN ERYTHROCYTE SOD AND PLASMA LPO LEVELS WITH SURVIVAL OF SKIN FLAP IN RADICAL MASTECTOMY

Both erythrocyte SOD and plasma LPO levels were determined in 30 cases of breast cancer subjected to radical mastectomy preoperatively and 0, 6, 12, 24, 48 and 72 hrs. postopratively. It was found that significant negative correlation existed between SOD and LPO levels (r=-0. 9064, t test P < 0. 01). The postoperative change of plasma LPO values had greater range of fluctuation and the change lasted longer than those of erythrocyte SOD. At the same time,as the level of SOD was found to be decreased and LPO level increased significantly (P<0. 05) in the tissue of skin flap at the time of completion of the operation,the changes of their levels in skin flap might be considered parallel to the changes in blood postoperatively. There was neutrocytic infiltration in the tissue of skin flap microscopically and electromicroscopical pictures showed endothelial damage of the capillaries. It might be conclude that the necorsis of skin flap follwing radical mastectomy was the results of endothelial damage of capillaries by the action of increased superoxide radicals.