布托啡诺联合罗哌卡因镇痛对大鼠创面愈合、瘢痕的影响及机制研究

目的研究布托啡诺和罗哌卡因对SD大鼠血液中IL-1、IL-6、IL-10,创面周围GM-CSF的表达、创面愈合及瘢痕组织的影响。方法取SPF级雄性SD大鼠64只,随机分为4组,B组大鼠鼠尾静脉注射布托啡诺0.3 mg/(kg·12 h),R组大鼠创面周围浸润注射0.5%的罗哌卡因1 mL/(kg·12 h),B+R组大鼠鼠尾静脉注射布托啡诺0.3 mg/(kg·12 h)和创面周围浸润注射0.5%的罗哌卡因1 mL/(kg·12 h),C组大鼠鼠尾静脉注射等容量0.9%氯化钠注射液。在造模后的第3、7、10天,每组随机取4只大鼠用ELISA法测定血清IL-1、IL-6、IL-10和创面GM-CSF的含量,每组剩余4只SD大鼠用来观察创面愈合时间和愈合后瘢痕面积。通过HE染色和MASSON染色病理切片观察创面病理变化。结果在第3天、第7天和第10天,B+R组IL-1、IL-6的含量低于C组(P0.05);在第3天和第10天,B组和B+R组IL-10的含量高于C组(P0.05);在第3天和第7天,B+R组的GM-CSF/BCA的比值高于C组和R组(P0.05);B组、R组和B+R组愈合时间均短于C组(P0.05),而B+R组在创面愈合率和瘢痕面积方面优于C组和R组(P0.05);B+R组的HE染色和MASSON染色组织学表现优于C组、B组和R组(P0.05)。结论布托啡诺联合罗哌卡因可以通过抑制IL-1和IL-6的表达、增强IL-10和GM-CSF的表达,使创面更快更好地愈合,减少创面愈合后的瘢痕面积。

Research on the impacts and mechanism of analgesia of butorphanol combined with ropivacaine on wound healing and scar in rats

Objective To research the impacts of butorphanol and ropivacaine on the expression of IL-1, IL-6 and IL-10 in blood, GM-CSF expression around wound, as well as wound healing and scar tissue in SD rats. Methods A total of 64 SPF male SD rats were selected and randomly divided into group B, group R, group B+R and group C. Rats in group B were injected with butorphanol of 0.3 mg/(kg·12 h) via tail vein, rats in group R were injected with 0.5% ropivacaine of 1 ml/(kg·12 h) around the wound, rats in group B+R were injected with butorphanol of 0.3 mg/(kg·12 h) via tail vein and 0.5% ropivacaine of 1 mL/(kg·12 h) by infiltration around wound respectively, while rats in group C were injected with 0.9% sodium chloride injection in equal volume via tail vein. On the 3rd, 7th and 10th day after modeling, 4 rats in each group were randomly selected to measure the contents of serum IL-1, IL-6, IL-10 and wound GM-CSF by ELISA method, and the remaining 4 SD rats in each group were used to observe the wound healing time and scar area after healing. Pathological changes of wounds were observed by HE staining and MASSON staining pathological section. Results On the 3rd, 7th and 10th day, the contents of IL-1 and IL-6 in group B+R were lower than those in group C (P < 0.05). On the 3rd, 7th and 10th day, the content of IL-10 in group B and group B+R was higher than that in group C (P < 0.05). On the 3rd, 7th and 10th day, the ratio of GM-CSF/BCA in group B+R was higher than that in group C and group R (P < 0.05). The healing time in group B, group R and group B+R was shorter than that in group C (P < 0.05).The wound healing rate and scar area in group B+R were superior to those of group C and group R (P < 0.05).Histological manifestations of HE staining and MASSON staining in group B+R were superior to those in group C, group B and group R(P < 0.05). Conclusion Butorphanol combined with ropivacaine can inhibit the expression of IL-1 and IL-6, and enhance the expressions of IL-10 and GM-CSF, so as to make the wound healing faster and better, and reduce the scar area after wound healing.