摘要： 目的:觀察四肢火器傷受不同劑量短波紫外線照射后,組織中羥脯氨酸含量的變化,以期分析紫外線照射對(duì)膠原蛋白合成的影響。方法:實(shí)驗(yàn)于2003-09/2004-09在解放軍總醫(yī)院理療科實(shí)驗(yàn)室和解放軍軍事醫(yī)學(xué)科學(xué)院放射醫(yī)學(xué)研究所完成。選用新西蘭大白兔90只,隨機(jī)數(shù)字法分為3組:30mJ/cm2照射組、60mJ/cm2照射組和對(duì)照組,每組30只。麻醉動(dòng)物后,以“五四”式手槍擊兔右股部肌肉豐滿處,造成貫通傷模型。常規(guī)清創(chuàng)后采用紫外線治療儀分別對(duì)3組實(shí)驗(yàn)動(dòng)物傷道進(jìn)行30s(30mJ/cm2)照射,60s(60mJ/cm2)照射和無照射干預(yù)。在致傷后第2和3天繼續(xù)在傷道內(nèi)進(jìn)行照射,日增加前次照射劑量的30%。采用化學(xué)法在傷后7,14,21,28,42,56和70d測(cè)量肉芽組織中羥脯氨酸含量的變化。結(jié)果:實(shí)驗(yàn)動(dòng)物82只進(jìn)入結(jié)果分析。①致傷后7d,各組大白兔組織中羥脯氨酸的含量無差別。②傷后14d,60mJ/cm2照射組羥脯氨酸的含量高于30mJ/cm2照射組和對(duì)照組[(11.91±0.49)mg/g,(10.88±0.61)mg/g,(10.35±0.85)mg/g,P<0.05];傷后21～56d,60mJ/cm2照射組傷口中的羥脯氨酸含量均高于30mJ/cm2照射組傷口和未照射組(P<0.01)。③傷后70d時(shí),各組羥脯氨酸的含量下降接近正常組織水平,60mJ/cm2照射組仍稍高于30mJ/cm2照射組和未照射組[(10.02±0.65)mg/g,(9.85±0.54)mg/g,(9.27±0.43)mg/g,P<0.05]。④在傷后21～56d30mJ/cm2照射組傷口中羥脯氨酸的含量高于對(duì)照組(P<0.05)。結(jié)論:短波紫外線照射能促進(jìn)傷口中羥脯氨酸的合成,增加膠原含量,60mJ/cm2照射的作用強(qiáng)于30mJ/cm2。 AIM:To investigate the changes of L-hydroxyproline(L-Hyp) level in the gunshot wounds on limbs after exposed to different doses of Ultraviolet C irradiation,so as to explore the effect of the radiation on collagen synthesis.METHODS:The experiment was performed in the laboratories of Department of Physiotherapy,General Hospital of Chinese PLA and Department of Pathology,Beijing Institute of Radiation Medicine from September 2003 to September 2004.Ninety New Zealand rabbits were randomly divided into 3 groups:30 mJ/cm2 irradiation group,60 mJ/cm2 irradiation group and control group with 30 rabbits in each group.The animal models of wound were established by shooting the muscle of right thigh with "54" type pistol.Immediately after debridement,the wounds of the two irradiation groups were irradiated under Ultraviolet for 30 seconds(30 mJ/cm2) and 60 seconds(60 mJ/cm2),respectively,the control group was not given irradiation.On days 2 and 3 after modeling,the wounds were treated with intra-wound irradiation,with the dose increasing 30% gradationally.The changes of L-Hyp level in the granulation were detected with the chemistry method on days 7,14,21,28,42,56 and 70.RESULTS:There were 82 animals involving in the result analysis.①There was no difference in the L-Hyp level among the three groups at the 7th day after modeling.②The L-Hyp level of the 60 mJ/cm2 group at the 14th day was significantly higher than both the 30 mJ/cm2 group and the control group [(11.91±0.49) mg/g,(10.88±0.61) mg/g,(10.35±0.85) mg/g,P < 0.05];from the 21st to the 56th day,the L-Hyp level in the 60 mJ/cm2 irradiation group was also significantly higher than both the 30 mJ/cm2 group and the control group(P < 0.01).③At the 70th day,the L-Hyp level of each group was decreased and approached to normal tissue level,but that of the 60 mJ/cm2 group was still higher than both the 30 mJ/cm2 group and the control group [(10.02±0.65) mg/g,(9.85±0.54) mg/g,(9.27±0.43) mg/g,P < 0.05].④The L-Hyp level of the 30 mJ/cm2 group was higher than the control group from the 21st to the 56th day after modeling(P < 0.05).CONCLUSION:Ultraviolet C irradiation is helpful to increase L-Hyp level in the gunshot wounds healing tissue,and accelerate the collagen synthesis.The effect of Ultraviolet C at dose of 60 mJ/cm2 is superior to that of 30 mJ/cm2.
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