血管细胞外基质和尿道细胞外基质修复兔尿道缺损的比较研究  

Comparative study on experimental defect in rabbit urethra repaired with vessel extracellular matrix and urethral extracellular matrix

作　　者：杨嗣星[1] 申复进[1] 姚颐[1] 金化民[1] 王玲珑[1] 

机构地区：[1]武汉大学人民医院泌尿外科,430060

出　　处：《中华泌尿外科杂志》2004年第12期854-856,共3页Chinese Journal of Urology

基　　金：湖北省自然科学基金资助项目 (2 0 0 3ABA187) ;湖北省教育厅资助项目 (2 0 0 3X12 3)

摘　　要：目的　寻求较理想的尿道修复材料。　方法　切取 10只家兔的腹主动脉和尿道各 3cm ,制备成血管细胞外基质 (VECM)和尿道细胞外基质 (UECM)。另 2 0只分别切除尿道 2 .5cm并随机分为VECM修复组和UECM修复组。两组均于修复术后 10d、3周、6周及 2 4周行组织再生情况研究 ;另于术后 10周、2 4周各取 2只行膀胱尿道造影 ;2 4周两组各取 2只行尿动力学检测和尿道镜检查。　结果　制备的VECM和UECM均为白色透明状 ,但VECM较UECM弹性和机械强度好。缺损修复术后10d ,基质中见单层上皮细胞且有血管长入ECM ,基质和受体尿道连接处有炎性细胞浸润 ;3周时基质管腔已完全被上皮细胞覆盖 ;6周时可见平滑肌细胞再生 ,炎性细胞消失 ;2 4周后其组织结构与正常尿道组织结构一致。VECM修复组和UECM修复组相比其组织再生过程无差异。尿动力学检测VECM修复组和UECM修复组的膀胱容量分别为 (30 .2± 1.6 )ml和 (32 .1± 1.4 )ml、尿道最高压分别为(15 .2 7± 1.36 )mmHg和 (14 .6 8± 1.6 5 )mmHg、尿道最低压分别为 (12 .4 9± 1.2 3)mmHg和 (11.96±0 .98)mmHg ,差异无统计学意义 (P >0 .0 5 )。膀胱尿道造影可见尿道壁完整光滑通畅 ,不能分辨移植区与正常组织 ,无尿液外渗 ,无梗阻及结石形成 ;Objective To seek an ideal material for replacement of urethral defect. Methods This study included 30 male rabbits.Vessel extracellular matrix (VECM) and urethral extracellular matrix (UECM) were obtained from 10 rabbits by decellularization process.The other 20 rabbits were randomly divided into experiment (VECM repair) group and control (UECM repair) group.In experiment group of 10 rabbits,a 2.5 cm segment of urethra was resected and replaced with 3.0 cm VECM graft.Then the regenerative segment was studied with histological technique by hematoxylin-eosin and van Gieson staining after 10 days,3,6 and 24 weeks postoperatively.The retrograde urethrography was used to evaluate the function of the regenerative urethra at 10 and 24 weeks after transplantation. Urodynamic evaluation and urethroscopy were preformed on 2 rabbits 24 weeks after operation.The 10 rabbits in control group underwent the exact same procedure as above but the urethral defect was repaired with UECM instead of VECM. Results The prepared VECM and UECM were transparent,with VECM of better elasticity and mechanical properties.At 10 days after operation,epithelial cells migrated from each side and small vessels were observed in the ECM.Minimal infiltration of inflammatory cells was observed in the host-matrix anastomosis;however,these cells completely disappeared 6 weeks after operation.The luminal surface of matrix was completely covered by urothelium after 3 weeks.Well formed smooth-muscle cells were first confirmed after 6 weeks.The regenerative tissue was equivalent to the normal urethral tissue at 24 weeks postoperatively.There was no significant difference in all evaluated items between experiment group and control group.Urodynamic evaluation and serial urethrograms demonstrated the bladder capacity of (30.2±1.6)ml vs (32.1±1.4) ml, the highest urethral pressure of (15.27±1.36)mmHg (1 mmHg=0.133 kPa) vs (14.68±1.65) mmHg,the lowest urethral pressure of(12.49±1.23)mmHg vs (11.96±0.98) mmHg in experiment and control groups;there was

关 键 词：血管细胞外基质 尿道细胞外基质 修复 兔 尿道缺损 比较研究 组织工程 

分 类 号：R699[医药卫生—泌尿科学]