兔尿道细胞外基质修复尿道创伤缺损及组织相容性研究  

Curative effect and histocompatibility of extracellular matrix in reconstruction of traumatic urethra defects in rabbits

作　　者：胡云飞[1] 杨嗣星[1] 王玲珑[1] 胡俊丹[1] 赵凯亮[1] 詹炳炎[1] 

机构地区：[1]武汉大学人民医院泌尿外科,430060

出　　处：《中华创伤杂志》2009年第2期160-163,共4页Chinese Journal of Trauma

摘　　要：目的探讨尿道细胞外基质修复尿道创伤缺损的疗效及其组织相容性。方法实验组20只家兔手术切除一段长约1．0—1．5em的尿道，人工造成尿道缺损模型。再用一段等长的尿道细胞外基质修复尿道缺损。另设对照组（仅在游离尿道后关闭切口，10只）和异体尿道移植组（配对互换移植，10只）。采用淋巴细胞转化实验及术后1，2，3，4周从兔耳缘静脉取血，应用流式细胞仪检测样本中T淋巴细胞亚群CD4^＋、CD8^＋及CD4^＋／CD8^＋动态变化，评估术后受体的免疫反应状态；术后10d、3，6及24周取修复段尿道，行组织学观察；术后24周行尿道造影、尿道镜及尿流动力学检查。结果实验组术后淋巴细胞刺激指数及外周血淋巴细胞亚群CD4^＋、CD8^＋及CD4^＋／CD8^＋比值和对照组比较，差异无统计学意义；但异体尿道移植组则高于对照组（P〈0．05）。术后3周起实验组上皮细胞覆盖细胞外基质的整个管腔；24周尿道平滑肌数量明显增多，接近正常的尿道组织结构。尿道造影及尿道镜检查显示尿道基质管壁光滑通畅。尿流动力学检测显示实验组与对照组比较，差异无统计学意义。结论尿道细胞外基质具有较好的组织相容性，是一种安全有效的尿道修复材料。Objective To study the effect and histocompatibility of urethral extracellular matrix in repair of traumatic urethra defects in rabbits. Methods Model of traumatic urethral defects was made by resecting 1.0-1.5 cm segment of the urethra in 20 rabbits. Then, the defects were repaired by a tube of extracellular matrix of the same length. The dynamic changes of CD4 ^＋ , CD8 ^＋ T cell and CD4 ＋ / CD8 ^＋ in peripheral blood were detected by flow cytometry at 1,2, 3 and 4 weeks after operation. In the meantime, the immunity response of rabbits was evaluated by lymphocyte transformation test. The repaired segments stained with hematoxylin-eosin （HE） and Van Gieson were studied by histologic and pathologic observations at 10 days, 3, 6 and 24 weeks postoperatively. The urodynamics, urethroscopy and urethrography were performed at 24 weeks postoperatively. Results There was no significant difference in aspects of stimulative index of lymphocyte transformation, T lymphocyte subsets CD4 ^＋ , CD8 ^＋ T cell and CD4 ^＋/CD8 ^＋ between experimental group and negative control group. Urothelium covered the whole surface of the matrix tube three weeks after operation. The smooth muscle cells increased nearly to normal urethral wall at 24 weeks. Urethroscopy and urethrography showed glossy matrix tube. There was no statistical difference upon urodynamics between experimental group and control group. Conclusion The urethral extracellular matrix has good histocompatibility and may be a safe and effective material for repairing urethra defects.

关 键 词：细胞外基质 创伤和损伤 尿道 兔 修复 

分 类 号：R699[医药卫生—泌尿科学]