尿道细胞外基质修复尿道缺损的研究  

Experimental defect in rabbit urethra repaired with urethral extracellular matrix

作　　者：杨嗣星[1] 王雪芬[1] 宋超[1] 胡云飞[1] 王玲珑[1] 金化民[1] 

机构地区：[1]武汉大学人民医院泌尿外科,430060

出　　处：《中华实验外科杂志》2005年第1期29-30,共2页Chinese Journal of Experimental Surgery

基　　金：湖北省自然科学基金资助项目 (2 0 0 3ABA1 87)

摘　　要：目的　寻求一种较理想的尿道修复材料。方法　 2 0只家兔尿道制成尿道细胞外基质 (ECM ) ;另 40只随机分 3组 :尿道ECM移植组 (实验组 ) ,对照组Ⅰ及对照组Ⅱ。实验组切除尿道 1.0～ 1.5cm后用尿道ECM修复并于术后 10d、3周、6周及 2 4周行组织再生情况观察 ;另于术后 10周、2 4周各取 4只行膀胱尿道造影 ;2 4周时实验组及对照组Ⅰ各取 4只行尿流动力学检测 ;2 4周实验组取 4只行尿道镜检查。结果　缺损修复术后 10d ,基质中见单层上皮细胞且有血管长入ECM ;3周时尿道ECM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组织相比差异无统计学意义。膀胱尿道造影无尿液外渗 ,无梗阻及结石形成。尿流动力学检测结果实验组与对照组Ⅰ差异无统计学意义 ;尿道镜检查证实尿道黏膜完整光滑 ,尿道内径及其形态正常。结论　尿道细胞外基质是一种理想的尿道修复材料。Objective To search for an ideal material forreplacement of urethral defect.MethodsExtracellular matrixwas obtained from the urethrals of 20 rabbits by decellularization process.Other 40 rabbits were divided randomly into three groups,including experimental group,control group Ⅰ and control group Ⅱ.In experimental group of 20 rabbits,the resected urethral of 1.0 1.5 cm was repaired by the urethral ECM.The regeneration segment stained with H&E and Van Gieson was studied by histological technique after 10 days,3 weeks,6 weeks and 24 weeks postoperatively.The retrograde urethrography was used to evaluate the function of the regeneration urethrals of 4 rabbits 10 weeks and 24 weeks after operation respectively.The 4 rabbits each in experimental group and control group Ⅰ were monitored for urodynamics.The 4 rabbits in experimental group were examined by urethroscopy 24 weeks after operation.Results Ten days after operation,epithelial cells were migrated from each side,and small vessels were observed in the ECM.The matrix and adjacent areas of the host tissue was infiltrated with inflammatory cells.The epithelium covered the ECM fully after 3 weeks postoperatively.At 6th week after operation,smooth muscle cells were regenerated and inflammatory cells disappeared.At 24th week after operation,the regeneration tissue was the same as the normal urethra.The urehrography and urodynamic evaluation revealed that there was no difference between the normal tissue and the regeneration one.Conclusion The urethral ECM appears to be an ideal material for urethral replacement.

关 键 词：尿道镜 细胞外基质 对照组 ECM 术后 缺损 尿道造影 消失 平滑肌细胞 形态 

分 类 号：R699.6[医药卫生—泌尿科学]