新型生物可降解支架材料生物特性及在损伤胆道修复中的应用  

A novel biodegradable scaffold: biological properties and application in bile duct repair

作　　者：马利锋[1] 李涛[1] 张立超[1] 刘国超[1] 王建龙[1] 

机构地区：[1]河北医科大学附属第二医院胆道微创外科,河北省石家庄市050000

出　　处：《中国组织工程研究》2016年第30期4434-4441,共8页Chinese Journal of Tissue Engineering Research

基　　金：河北省卫生厅医学科学研究重点课题项目(20120061)~~

摘　　要：背景:多种原因会导致胆道损伤的出现,损伤后的修复重建难度较大。支架置入是一种常用的方法,但以往大多使用金属或者塑料支架,容易导致一定不良反应的出现。目的:探讨新型生物可降解支架材料的生物特性及其在胆道损伤中的修复效果。方法:利用人新鲜胆汁检测新型生物可降解支架材料生物特性,观察其在不同时间的降解情况。纳入巴马小型猪30只,随机分为观察组和对照组,每组15只,均制备胆道损伤模型。对照组实施胆管间断缝合修复,观察组实施新型生物可降解支架联合大网膜修复治疗。观察支架的生物学性能,对比观察2组动物不同时间肝酶及血总胆红素检测水平,苏木精-伊红染色、Masson染色结果以及α-平滑肌肌动蛋白免疫组化检测结果。结果与结论:(1)术前及术后1,3,6个月对2组的肝酶及血总胆红素进行检测,不同时间组间及组内比较差异均无显著性意义(P均>0.05);(2)苏木精-伊红染色和Masson染色观察结果发现,术后不同时间观察组的吻合口炎性反应与纤维增生程度均轻于对照组;(3)术后1,3个月,2组α-平滑肌肌动蛋白阳性评分均呈现出不断增加的情况,术后3个月均达到最大值,之后开始下降。且术后3,6个月,观察组的α-平滑肌肌动蛋白阳性评分均显著低于对照组(P<0.05);(4)结果表明,制备的新型生物可降解支架材料具有良好的生物特性,应用于胆道损伤中可以获得理想的修复效果。BACKGROUND： A variety of factors contribute to biliary injury that is difficult to be repaired. Stent implantation is extensively used for bile duct injury, but either scaffolds made by metal or plastics can lead to certain adverse reactions. OBJECTIVE： To explore the biological characteristics of a novel biodegradable scaffold and its repair effects on bile duct injury. METHODS： The biological characteristics of the novel biodegradable scaffold were detected by fresh bile, and its degradation was observed at different time points. Thirty Bama mini pigs were included and were randomly divided into observation group （n=15） and control group （n=15）. After bile duct injury models were prepared, the control group was subjected to the bile duct interrupted suture, while the observation group was subjected to the novel biodegradable scaffold combined with omentum majus. The biological properties of the scaffolds were observed. Hepatic enzymes and serum total bilirubin levels were detected, as well as hematoxylin-eosin staining, Masson staining and immunohistochemistry detection of a-smooth muscle actin were performed. RESULTS AND CONCLUSION： Before and 1,3 and 6 months after surgery, hepatic enzymes and total bilirubin of two groups were detected, and neither intra-group nor intergroup comparisons had significant differences （P 〉 0.05）. Hematoxylin-eosin staining and Masson staining revealed that inflammatory reactions and fiber hyperplasia at the anastomotic site in the observation group were lighter than those in the control group at different time points after surgery. The a-smooth muscle actin-positive scores in both two groups were in a rise at 1 and 3 months after surgery, and peaked at the 3nd month, and then began to decline. Moreover, the a-smooth muscle actin-positive scores in the observation group were significantly lower than those in the control group at 3 and 6 months after surgery （P 〈 0.05）. These results show that the novel biodegradable scaffold has good biological charact

关 键 词：胆道 支架 免疫化学 组织工程 生物材料 材料相容性 胆道损伤 可降解材料 生物特性 肝酶 血总胆红素 修复 

分 类 号：R318[医药卫生—生物医学工程]