膀胱脱细胞胶原基质复合血管内皮生长因子修复兔尿道缺损  

Bladder acellular matrix combined with vascular endothelial growth factor repairs rabbit urethral defects

作　　者：顾绍栋[1] 周云[2] 熊前卫 张亚[3] 杨金龙 Gu Shaodong;Zhou Yun;Xiong Qianwei;Zhang Ya;Yang Jinlong(Department of Pediatric Surgery,Lianyungang No.1 Hospital,Lianyungang 222002,Jiangsu Province,China;Department of Pediatric Urology,Children Hospital of Soochow University,Suzhou 215025,Jiangsu Province,China;Laboratory,Children Hospital of Soochow University,Suzhou 215025,Jiangsu Province,China;Department of Pediatric Surgery,Wuxi No.8 People’s Hospital,Wuxi 214000,Jiangsu Province,China)

机构地区：[1]连云港市第一人民医院儿外科,江苏省连云港市222002 [2]苏州大学附属儿童医院小儿泌尿外科,江苏省苏州市215025 [3]苏州大学附属儿童医院实验室,江苏省苏州市215025 [4]无锡市第八人民医院小儿外科,江苏省无锡市214000

出　　处：《中国组织工程研究》2018年第34期5477-5483,共7页Chinese Journal of Tissue Engineering Research

基　　金：江苏省临床医学科技专项-新型临床诊断技术攻关项目(BL2012051)~~

摘　　要：背景:采用膀胱无细胞基质作为游离移植物修复尿道缺损,诱导尿道再生取得一定的成果,但该方法仍未能从根本上解决移植物血管再生不足的问题。目的:观察复合血管内皮生长因子的异种膀胱脱细胞基质修复兔尿道缺损的效果。方法:将30只成年新西兰大白兔随机分为5组,每组6只,模型组、对照组、实验组均制作尿道缺损模型,随后对照组、实验组分别采用猪膀胱脱细胞基质、复合血管内皮生长因子的猪膀胱脱细胞基质进行修复,同时设立正常组、假手术组。术后4,12周分批处死动物,进行尿道造影、尿流率及免疫组织化学检测。结果与结论:(1)实验组术后4,12周的平均尿流率高于模型组、对照组(P <0.05),与正常组、假手术组比较无差异;(2)术后12周尿道造影显示,实验组尿路线条流畅;模型组、对照组尿路线条欠流畅;(3)苏木精-伊红染色显示,模型组胶原纤维细胞较多,纤维排列紊乱,有较多淋巴细胞浸润;实验组胶原基质基本降解,新生胶原纤维排列规律,其间血管较多,未见血管瘤等;对照组见团块状胶原沉积,视野内血管较少;(4)术后12周Masson染色显示,实验组胶原组织沉积明显少于对照组、模型组(P <0.05),接近正常组和假手术组(P> 0.05);(5)术后12周CD31染色显示,实验组新生血管数量明显多于对照组、模型组(P> 0.05),接近正常组和假手术组(P> 0.05);(6)术后12周a-SMA免疫组织化学染色显示,实验组再生肌肉含量明显高于对照组和模型组(P <0.05),接近正常组和假手术组(P> 0.05);(7)结果表明,复合血管内皮生长因子的异种膀胱脱细胞基质修复兔尿道缺损,可促进移植物局部血管新生,提高再生尿道肌肉含量,加速局部胶原降解,改善尿道再生微环境,促进尿道更好地再生。BACKGROUND:The use of bladder acellular matrix as a free graft to repair urethral defects and induce urinary tract regeneration has achieved certain results,but this method cannot fundamentally solve insufficient angiogenesis of the graft.OBJECTIVE:To observe the effect of bladder acellular matrix(BAM)combined with vascular endothelial growth factor(VEGF)in the repair of rabbit urethral defects.METHODS:Thirty adult New Zealand rabbits were randomly allocated into five groups(n=6 per group),including healthy control group,sham operation group,model group,BAM group,and BAM combined with VEGF group(VEGF-BAM group).Animal models of urethral defect were made in the latter three groups.The animals were sacrificed at 4 and 12 weeks after surgery,respectively.The penis was immediately harvested for standardized passive flowmetry,urethral radiography and subsequently fixed for immunohistochemical staining for evaluation.RESULTS AND CONCLUSION:(1)The average urinary flow rate of the VEGF+BAM group was significantly higher than that of the model group and BAM group at 4 and 12 weeks after surgery(P<0.05),while there was no difference from the healthy control group and sham operation group.(2)Urethral radiography at 12 weeks after surgery indicated that urethra continuity was repaired with no urethral fistula in the VEGF+BAM group,but not incompletely in the model and BAM groups.(3)Hematoxylin-eosin staining results indicated there were more collagen fibers and infiltrated lymphocytes in the model group,with the fiber arrangement being disordered;the collagen matrix in the VEGF+BAM group was basically degraded,new collagen fibers arranged regularly,and there were many blood vessels,but no hemangioma;and in the BAM group,massive collagen deposition and less blood vessels were observed.(4)Masson staining results indicated that less collagen deposition was observed in VEGF+BAM group compared with BAM group and model group at 12 weeks after surgery(P<0.05),which was similar to the healthy control group and sham operation group(P

关 键 词：膀胱脱细胞基质 血管内皮生长因子 组织工程 尿道缺损 兔 生物材料 膀胱 血管内皮生长因子类 组织工程 

分 类 号：R318[医药卫生—生物医学工程]