脱细胞基质管腔人工仿真胆管的体内重建：动物实验初步报告  

In vivo reconstruction of artificially simulated biliary tracts with decellularized matrix lumen., preliminary animal experiment

作　　者：周荣幸[1] 程南生[1] 李富宇[1] 

机构地区：[1]成都,四川大学华西医院胆道外科,610041

出　　处：《腹部外科》2014年第5期317-324,F0002,I0001,共10页Journal of Abdominal Surgery

基　　金：国家自然科学基金资助项目（No.30972923）

摘　　要：目的探讨脱细胞管腔基质人工仿真胆管支架材料（人工仿真胆管）修复胆管缺损的动物体内实验疗效。方法本实验采用前期制备的人工仿真胆管，应用于封闭群内江猪（18只）胆管缺损动物实验模型，探讨其体内修复效果，并根据术中是否安置支架分为支架组、无支架组，另设假手术组为对照每组各6只。术后不同时期检测相关指标，探讨人工胆管修复胆管缺损的实验疗效。结果体内实验发现，支架组、假手术组动物无死亡，无支架组实验动物分别植入术后第2、7、8和40天全部死亡。支架组大体标本未见明显胆漏，吻合口无明显狭窄，植入段胆管未见明显狭窄及管腔塌陷；无支架组大体标本可见植入段胆管狭窄，呈急性梗阻性化脓性胆管炎表现。实验室检查显示：支架组、假手术组胆管植入术后血清总胆红素（TB）无明显升高，无支架组动物在术后不同时间均有不同程度的血清TB升高，最高达到413．2μmol／L。组织学观察显示：植入术后第100天，形成较为完整的类似新生胆管样结构，整个胆管腔基本被类似正常胆管上皮的组织覆盖，无支架组标本可见吻合口狭窄明显，人工胆管挛缩、纤维化、管腔阻塞，局部组织结构混乱，炎性细胞浸润；免疫荧光染色示，在植入术后第100天支架组人工仿真胆管植入段的细胞角蛋白19（CK19）和上皮细胞黏附分子（HEA125）表达与植入段吻合口的上、下端正常胆管黏膜上皮的CK19和HE125表达相接近。结论人工仿真胆管的研发可能会为临床胆管缺损性疾病的治疗提供潜在的治疗途径。Objective To discuss artificially simulated biliary stent mateirals with decellularized luminal matrix （artificially simulated biliary tract） and explore their experimental and curative effects. Methods Artificial bile duct was established in the animal model of bile duct injury by closed group Neijiang pigs for examing its in vivo repairing effect. According to whether placed stent was divided into three groups of stent, stentless and sham operation. Different variables were tested postoperatively. Results No animals died in the stent and control groups while all animals in the stentless group died at Days 2, 7, 8 and 40 after implantation. Gross samples had no obvious bile leakage in the stent group. It had no obvious stricture or lumen collapse in biliary ducts at the implanted section. In the stentless group, biliary stricture at the implanted section showed signs of acute obstructive and suppu- rative cholangitis. Serum total bilirubin had no obvious improvements after implantation in stent and control groups while it increased to varying extents with a peak value of 413.2 μmol/L. Histologically relatively complete structure similar to that of neonatal biliary ducts formed at Day 100 post-implanta- tion. The whole biliary duct was basically covered by tissues similar to epithelium of normal biliary ducts. Tissue samples in the stentless group had obvious anastomotic stricture. And artificial biliary ducts suffered contracture, fibrosis and luminal obstruction~ partial tissue structure was chaotic. Im- munofluorescent staining related to inflammatory cell infiltration showed CK19 and HEAl25 stainingat Day 100 post-implantation in the stent group. And the expressions of CKI9 and HEAl25 at the im planted section of artificially simulated biliary ducts approximated those of mucous epithelium of nor- mal biliary ducts at upper and lower ends of anastomotic stoma at the implanted section. Conclusions The artificially simulated biliary tract might may provide a new treatment for various bile duct defect diseas

关 键 词：胆管 胆管狭窄 胆管缺损 人工胆管组织工程 

分 类 号：R657.46[医药卫生—外科学]