自体管状肉芽组织重建兔全周尿道的功能组织学评估  

Urethral reconstruction with autologous tubular granulation tissues:functional and histological evaluation in male rabbits

作　　者：姜士伟 闫磊[1] 唐悦清[1] 任巨超[1] 臧元伟 张永振 顾刚利[1] 徐忠华[1] 

机构地区：[1]山东大学齐鲁医院泌尿外科,山东济南250012

出　　处：《山东大学学报（医学版）》2017年第11期15-21,共7页Journal of Shandong University:Health Sciences

基　　金：国家自然科学基金(81372335);国家青年自然科学基金(81400696);山东省青年自然科学基金(ZR2014HQ026)

摘　　要：目的探讨应用自体皮下诱导生成的管状肉芽组织重建兔全周尿道的可行性。方法 18只雄性兔分为实验组与对照组,每组9只,全周游离并切除1.0 cm前尿道,实验组应用自体皮下诱导生成的管状肉芽组织原位修复尿道缺损,对照组行单纯端端吻合。术后1、2及6个月行尿道造影、大体观察、组织学检测及Western blotting检测,动态评估新尿道通畅度及组织再生。结果组织学及透射电镜检测显示,新生管状肉芽组织富含胶原纤维及肌成纤维细胞。实验组术后尿道腔保持通畅,对照组则发生进行性狭窄。实验组术后移植物表面逐渐覆盖完整的尿路上皮层,上皮下可见排列日趋致密规则的新生平滑肌束。Western blotting示实验组随术后时间延长,移植物细胞广谱角蛋白AE1/AE3及α-平滑肌肌动蛋白表达量均逐渐增加,术后6个月其表达量接近正常尿道。结论自体皮下诱导生成的管状肉芽组织可成功修复兔1.0 cm长前尿道缺损。Objective To evaluate the feasibility by using autologous tubular granulation tissues for urethral reconstruction. Methods A total of 18 male rabbits were divided into the experimental group（ n = 9） and control group（ n =9）. A pendulous urethral segment of 1. 0 cm was excised in all rabbits. In the experimental group,urethroplasty was performed with autologous tubular granulation tissues. In the control group,re-anastomosis was performed. Serial urethrography,general observation,histological detection and Western blotting were performed 1 month,2 and 6 months after operation to dynamically evaluate patency degree and tissue regeneration. Results Histological and transmission electron microscopy of the autologous granulation tissues showed densely-arranged collagens and myofibroblasts. Urethrography showed the neo-urethra in the experimental group remained wide patent at each time point,while strictures developed in the control group. Histologically,layers of urothelium surrounded by increasingly organized smooth muscles were observed. Western blotting showed expressions of pan-cytokeratin AE1/AE3 and α-smooth muscle actin increased gradually with time,which reached similar level with normal urethra 6 months postoperatively. Conclusion Autologous tubular granulation tissues grown subcutaneously can be used to repair urethral defect of 1. 0 cm in male rabbits.

关 键 词：尿道重建 自体移植物 肉芽组织 尿道狭窄 

分 类 号：R695[医药卫生—泌尿科学]