封闭负压引流技术对失感觉神经支配创伤愈合中Bcl-2与NGF/NGF mRNA表达的影响

目的　研究封闭负压引流技术 (vacuum assistedclosure ,VAC)对失感觉神经支配的创面愈合过程中Bcl 2与NGF表达的影响。方法　将 80只SD大鼠随机分成四组 (每组 2 0只 ) ,即实验组(T组 ) :施加VAC的失去神经支配创面 ;对照组 1(C1) :未施加VAC的失去神经支配的创面 ;对照组2 (C2 ) :施加VAC的正常神经支配的创面 ;对照组 3(C3) :未施加VAC的正常神经支配的创面。T、C2组施加间断性VAC每日 3次 ,负压 80mmHg。伤后 1、3、6、9、12d ,四组同时取材 ,采用免疫组化和原位杂交检测各组各时间点Bcl 2与NGF/NGFmRNA表达。结果　在伤后C2组、C3组Bcl 2与NGF/NGFmRNA表达明显 ,水平逐渐升高 ,至第 9天达最高 ,然后降低 ,C2组较C3组Bcl 2和NGF/NGFmRNA维持相对高的状态 (P <0 .0 5 )。T、C1组创缘和肉芽组织中Bcl 2与NGF/NGFmRNA表达相对C2、C3组处于较低水平 (P <0 .0 5 )。结论　VAC通过增强创面组织抑制凋亡相关基因蛋白的表达 ,影响内源性NGF表达 ,具有明显的促进创面愈合的作用。

Influence of vacuum-assisted closure technique on expression of Bcl-2 and NGF/NGFmRNA during wound healing

Objective To explore the influence of vacuum-assisted closure technique(VAC) on expression of Bcl-2 and NGF during wound healing. Methods Eighty Sprague-Dawley rats were randomly divided into 4 groups with 20 rats of each. Group T was the experimental group;group C1,C2 and C3 were the control groups. In group T and group C1,capsaicin was injected subcutaneously to the back of the rats to destroy the sensory nerve. VAC was employed to the wound of the rats in group T and C2 three times a day at 80 mmHg negative pressure. In all the groups,tissue samples were taken from the wound edge and granulation at 1,3,6,9 and 12 days after the injury.Immunohistochemistry and in situ hybridization were used to detect the expression of Bcl-2 and NGF/NGFmRNA in the samples. Results In group C2 and C3,the expression of Bcl-2 and NGF/NGFmRNA was obvious,which increased gradually and reached the peak at the 9th day. In the process of wound healing,the expression Bcl-2 and NGF/NGFmRNA was higher in the group C2 than in group C3 ( P <0 ^05).The expression Bcl-2 and NGF/NGFmRNA in group T and C1 was lower than group C2 and C3( P <0 ^05). Conclusion The application of the vacuum-assisted closure technique during wound healing increases the expression of the apoptosic modulation related protein Bcl-2 and affects the expression of NGF/NGFmRNA,which may promote the wound healing process.