富含骨髓间充质干细胞的脱细胞真皮基质补片修复大鼠肛门括约肌损伤的实验研究  

Experimental study of acellular dermal matrix biological patch enriched with bone marrow mesenchymal cells for the treatment of external anal sphincter injury

作　　者：周井义[1] 汪名飞[1] 陈炜[1] 丁召[1] 江从庆[1] 钱群[1] 刘志苏[1] 

机构地区：[1]武汉大学中南医院结直肠肛门外科湖北省肠病医学临床研究中心湖北省肠病重点实验室,430071

出　　处：《中华胃肠外科杂志》2012年第12期1256-1260,共5页Chinese Journal of Gastrointestinal Surgery

基　　金：基金项目：国家自然科学基金（81070387）

摘　　要：目的探讨骨髓间充质干细胞（BMSC）联合脱细胞真皮基质（ADM）补片治疗大鼠肛门括约肌损伤的可行性。方法体质量300-400g的Wistar大鼠30只，按随机数字表法分成A、B、C3组．制成肛门括约肌损伤模型备用。2周后。A组直接进行端端缝合修补。B组端端缝合后加修补处覆盖ADM补片．C组端端缝合后加修补处覆盖种植有MSC的ADM补片。6周后．各组大鼠整体取出包括肛管及下端直肠在内的环形标本．行苏木精．伊红和Masson三色染色．观察组织形态学改变。结果2周后大鼠肛门括约肌损伤模型建立成功，模型鼠肛门潮湿，肛门周围有稀便。经过修补处理后6周。组织学观察见A、B组肛门括约肌损伤处被纤维结缔组织填充并伴炎性细胞浸润．在损伤修补处可见大量被染成蓝色的散乱胶原纤维沉积．未见明显血管增生。c组肛门括约肌损伤修补处蓝色胶原沉积较A、B组减少．可见被染成红色的肌纤维分布。结论富含BMSC的ADM补片移植可在一定程度上促进大鼠损伤肛门括约肌的再生并减轻瘢痕形成。Objective To investigate the feasibility of bone marrow mesenchymal stem cells （MSC）with the acellular dermal matrix （ADM） biological patch for the treatment of external anal sphincter injury on the animal models. Methods Thirty Wistar rats with sphincter injury were randomly divided into three groups. Group A underwent end to end sphincteric repair directly, group B underwent end to end repair and then covered by ADM patch, and group C underwent end to end repair and then covered by ADM which was previously seeded with MSC. After six weeks, the whole ring specimens including anal canal and lower rectum were removed. The hematoxylin and eosin stain and Masson trichrome stain were performed to observe the change of histomorphology. Results Two weeks later, the majority of rat models presented with moist anus and erissum with loose stools, which indicated that the model was established successfully. Six weeks after repair, in group A and B, the suffusion of fibrous connective tissue and the infiltration of inflammatory cells were observed at the repair site of sphincter. And lots of collagen fiber which was stained into blue deposited dispersedly at the site of repair with no obvious proliferation of capillaries. However, in group C, the blue eollagenous fiber which deposited at the sphincter injury site was less than that in groups A and B. Muscle fibers were observed to be stained into red distributed dispersedly at the repair site of sphincter in group C. Conclusions Transplantation of ADM biological patch rich in bone MSC can partly improve the regeneration of rat injured anal sphincter and lessen the formation of cicatrix.

关 键 词：肛门括约肌损伤 外科修补 骨髓间充质干细胞 脱细胞真皮基质 

分 类 号：R657.1[医药卫生—外科学]