脂肪基质血管成分移植促进随意皮瓣成活的实验研究

目的探讨脂肪基质血管成分(Stromal vascular fraction,SVF)移植是否可以促进随意皮瓣成活,及其作用的相关机制。方法分离4周龄Wistar大鼠脂肪中的SVF及骨髓中的单个核细胞(BM-MNCs),RT-PCR检测VEGF和bFGF在两种细胞中的表达。根据移植细胞的不同,将24只Wistar大鼠分成3组,分别为对照组、BM-MNCs组和SVF组。在大鼠背部设计一个10 cm×3 cm大小的矩形皮瓣,分别将含有5×107个SVF及BM-MNCs的混悬液各1 mL均匀注射至皮下组织层,对照组单纯注射1 mL PBS。2 d后,皮瓣掀开原位缝合,术后7 d统计皮瓣的成活率。取各组皮瓣相同部位的组织,实时定量PCR检测组织中VEGF和bFGF基因的表达。结果 SVF和BM-MNCs细胞中VEGF和bFGF的表达无明显差别(P>0.05)。皮瓣原位缝合后7 d,SVF组和BM-MNCs组皮瓣的成活率分别为(72.2±2.0)%和(76.4±3.1)%,均明显高于对照组的(56.8±4.6)%(P<0.05)。实时定量PCR检测发现SVF组和BM-MNCs组皮瓣组织中VEGF和bFGF基因的表达明显升高。结论 SVF移植入皮瓣后可以通过旁分泌生长因子如VEGF和bFGF等增加皮瓣的成活面积。

Effect of Stromal Vascular Fraction Transplantation on Improvement of Random Skin Flap Survival

Objective To investigate effect of SVF transplantation on survival of random skin flap and explore the relative mechanism.Methods SVF and bone marrow-derived mononuclear cells（BM-MNCs） were isolated from 4-week-old Wistar rats.The gene expressions of VEGF and bFGF in SVF and BM-MNCs were detected by RT-PCR.Twenty-four Wistar rats were selected to make 10 cm × 3 cm skin flap at back,and were randomly divided into 3 groups according to different suspension fluid which were injected subcutaneously to treat flaps（n=8）： control group,BM-MNCs group and SVF group.Two days later,the flap was raised and sutured.Seven days after the operation,the survival of skin flap in 3 groups was observed.A piece of flap at same place was taken and quantitative expression of VEGF and bFGF was detected by quantitative PCR.Results The expressions of VEGF and bFGF were same in SVF and BM-MNCs.The survival ratio of skin flap in BM-MNCs group（76.4±3.1）% and SVF group（72.2±2.0）% were both obviously higher than the control group（56.8±4.6）%,P0.05.The expression of VEGF and bFGF in BM-MNCs and SVF groups was distinctly higher than the control group.Conclusion SVF can improve the viability of skin flap by the para-secreting of VEGF and bFGF.