跨区皮瓣切取后choke血管管径的定量分析及MMP-2与MMP-9的表达

doi:10.13418/j.issn.1001-165x.2017.05.010

中国临床解剖学杂志 ›› 2017, Vol. 35 ›› Issue (5): 526-531.doi: 10.13418/j.issn.1001-165x.2017.05.010

跨区皮瓣切取后choke血管管径的定量分析及MMP-2与MMP-9的表达

陈永中¹，　黄俊英²，　薛兰²，　张锦裕²，　刘胜伟²，　董国强¹，　钱升¹，　蔡俊雄¹，　王燕亭³

1.福建省永安市立医院骨科，福建三明 366000；　2.福建医科大学神经生物研究所人体解剖与
组织胚胎学系，福州 3501083；　3.厦门医学院医学技术系，福建厦门 361023

出版日期:2017-09-25 发布日期:2017-10-30
通讯作者: 王燕亭，讲师，E-mail:278296548@qq.com
作者简介:陈永中(1974-), 福建龙岩人，副主任医师，主要从事四肢创伤皮肤软组织缺损皮瓣修复，Tel:18950968897, E-mail:yacyz 0316@sohu.com
基金资助:
福建省属高校基金（JK2014019）；福建省大学生创新创业训练计划（201610392001）

The vascular evolution of an extended flap on the dorsum of rats and the involvement of MMP-2 and MMP-9

CHEN Yong-zhong¹, HUANG Jun-ying²， XUE Lan², ZHANG Jin-yu²，LIU Sheng-wei², DONG Guo-qiang¹, QIAN Sheng¹, CAI Jun-xiong¹, WANG Yan-ting³

1. Department of Orthopaedics, Yongan Municipal Hospital, Sanming 366000，Fujian, China; 2. Institute of Neuroscientific Study, Department of Human Anatomy and Embryology, Fujian Medical University, Fuzhou 350108, China; 3.Department of Medical Technology, Xiamen Medical College, Xiamen 361023, Fujian, China

Online:2017-09-25 Published:2017-10-30

摘要/Abstract

摘要：

目的　探讨MMP-2与MMP-9在Choke血管演变过程中的表达情况。方法　SD 大鼠40 只，体重(310±10)g。在大鼠背部一侧切取髂腰动脉穿支为蒂，宽3 cm，长10 cm的皮瓣。术后将皮瓣分如5个时间点，在每个时间点切取髂腰动脉与肋间后动脉穿支之间的Choke区组织，利用Western blot、明胶酶谱法及免疫组化对MMP-2与MMP-9的表达情况进行分析。利用皮窗技术对Choke血管管径的变化进行定量分析。结果　 Western blot结果检测表明皮瓣术后MMP-2、MMP-9的表达量均有所增高，MMP-9以术后1 d增高最为显著；明胶酶谱结果显示，术后MMP-9的活性明显增高，以术后1 d增高最为显著，而MMP-2的活性没有显著差异。MMP-2免疫阳性细胞主要表达在血管内皮，MMP-9主要表达在血管腔内及血管内皮。PGP9.5免疫组织化学显色，皮瓣切取后3d皮瓣内的轴突已经完全退变。结论　通过对皮瓣内血管演变过程进行定量分析，在形态学上验证了跨区皮瓣术后前3 d静脉血“迷宫式回流”，之后主要通过轴型静脉进行回流的假说。在跨区皮瓣术后血管的形态学演变中MMP-9可能扮演比MMP-2更重要的角色。

关键词: , 跨区皮瓣, 　Choke血管, 　MMP-2, 　MMP-9

Abstract:

Objective　Toinvestigate whether MMPs are involved in the dilation process of choke vessels after flap elevation.　Methods　The model of an extended flap based on theiliolumbar perforator with a size of 10cm×3cm was established on the dorsum of rats. The dorsal skinfold chamber technique was adopted for observation of the vascular morphological evolution of flaps on 20 rats on a macroscopic level. 25 rats underwent flap elevation and were equally divided into five groups based on time points, i.e, 0, 1, 3, 5, 7 days after flap elevation. Tissues on the choke zone was harvested and prepared for analysis of MMP-2 and MMP-9 by western blot, immunohistochemistry and gelatin zymography.　Results The diameter of the arteries in the choke zone increased after flap elevation, reaching the peak on day 3, which was 80% larger than that on day 0. The diameter of veins in the choke zone, particularly that of the communicating venules, increased drastically in the first three days after flap elevation. The western blot analysis revealed significantly increased expression of MMP- 2 and 9 in the choke zone following surgery. The Immunohistochemistry analysis revealed expression of MMP-2 and 9 being located mainly in the endothelia. The gelatin zymography analysis revealed only the increased activity of MMP-9 following flap creation.　Conclusions　This study offered the first morphological evidence for the assumption that venous blood of an extended flap drains through the bypass route in the first three days after surgery and then through the deinnevated veins later on. The MMP-9 might play a more important role than MMP-2 in the morphological evolution of vasculature in the flap.

Key words: Extended flap, 　Choke vessels, 　MMP-2, 　MMP-9

陈永中,黄俊英,薛兰,张锦裕,刘胜伟,董国强,钱升,蔡俊雄,王燕亭. 跨区皮瓣切取后choke血管管径的定量分析及MMP-2与MMP-9的表达[J]. 中国临床解剖学杂志, 2017, 35(5): 526-531.

CHEN Yong-zhong, HUANG Jun-ying， XUE Lan, ZHANG Jin-yu，LIU Sheng-wei, DONG Guo-qiang, QIAN Sheng, CAI Jun-xiong, WANG Yan-ting. The vascular evolution of an extended flap on the dorsum of rats and the involvement of MMP-2 and MMP-9[J]. Chinese Journal Of Clinical Anatomy, 2017, 35(5): 526-531.

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跨区皮瓣切取后choke血管管径的定量分析及MMP-2与MMP-9的表达

The vascular evolution of an extended flap on the dorsum of rats and the involvement of MMP-2 and MMP-9

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