脐带间充质干细胞移植治疗子宫切口瘢痕缺陷大鼠的疗效观察  

Effects of WJMSC transplantation on cesarean scar defect in a rat model

作　　者：罗惠娟[1] 王宁[2] 周娟[1] 汤小湄[1] 陈宇毅[1] 罗文斌[1] 肖小敏[1] LUO Hui-juan;WANG Ning;ZHOU Juan;TANG Xiao-mei;CHEN Yu-yi;LUO Wen-bin;XIAO Xiao-min(Department of Obstetrics,The First Affiliated Hospital of Jinan University,Guangzhou 510632,China;Department of Obstetrics,Shenzhen Second People’s Hospital,Shenzhen 518035,China)

机构地区：[1]暨南大学附属第一医院产科,广东广州510632 [2]深圳市第二人民医院产科,广东深圳518035

出　　处：《中国病理生理杂志》2018年第11期2079-2084,共6页Chinese Journal of Pathophysiology

基　　金：广东省医学科学技术研究基金资助项目(No.A2015021)

摘　　要：目的:将脐带华通胶间充质干细胞(WJMSCs)移植到子宫切口瘢痕缺陷(PCSD)模型大鼠体内,探讨其治疗效果。方法:取雌性SD大鼠50只、将其随机分为3组:正常手术组(N-O组)10只、模型对照组(M-C组)20只和模型治疗组(M-T组)20只。孕第19天N-O组剖宫取胎后连续缝合子宫切口;M-C组与M-T组剖宫产术后子宫肌壁注射脂多糖(LPS)联合电凝(功率为10 W)子宫切缘,间断缝合切口。M-T组分A、B亚组(各10只),A组静脉注射0.5 m L+阴道灌注0.5 m L(1×10~9/L)WJMSCs,B组阴道灌注1 m L同浓度WJMSCs,每周1次,共3次;M-C亦分A、B亚组(各10只),与M-T组同样方法处理,仅将生理盐水替代WJMSCs。各组治疗后第1和4周,分别处死6和4只,留双侧子宫进行HE染色、Masson染色、肌动蛋白(actin)和细胞角蛋白免疫组化染色,通过体视学分析,检测子宫肌层和内膜的修复情况。结果:WJMSCs治疗后第1和4周,M-C组子宫肌层厚度和actin体积密度(Vv)均显著低于N-O组,肌层胶原纤维Vv和内膜缺陷率高于N-O组(P<0.05);WJMSCs治疗后第1和4周,M-T的A和B组的肌层厚度和actin Vv均显著高于M-C组,肌层胶原纤维Vv低于M-C组;M-C组内膜缺陷率高于其它组(P<0.05)。结论:WJMSCs可促进PCSD大鼠子宫肌层结构和功能的修复。静脉+局部联合治疗和单纯阴道治疗效果无明显差别。AIM:To evaluate the effects of transplantation of Wharton jelly-derived mesenchymal stem cells(WJMSCs)on SD rats with previous cesarean scar defect(PCSD).METHODS:SD rats(n=50)were randomly divided into 3 groups:10 in normal operation group(N-O group),20 in model control group(M-C group)and 20 in model treatment group(M-T group).On the 19th day of pregnancy,thread was used for continuous suture after the caesarean section(C-S)in N-O group.After C-S,LPS(1 g/L,1 mL/kg)was injected in uterine muscle walls and electrocoagulation(power=10 W)was used in bilateral uterine incision with interrupted suture in both M-C and M-T groups.The rats in M-T group was further divided into A and B subgroups,with 10 rats each.The rats in group A were treated by intravenous injection and vaginal perfusion,both with 0.5 mL of 1×10 9/L WJMSCs,while the rats in group B were treated by vaginal perfusion with 1 mL of WJMSCs,once a week,totally 3 times.The rats in M-C group were also divided into A and B subgroups(10 rats per group)and treated by the same way as M-T group,only except that saline was used instead of WJMSCs.At the 1st and 4th weeks after the treatment was finished,6 and 4 rats were executed in every group,respectively.The uterine specimens with Masson and immunohistochemical staining were observed for determining the expression of actin and cytokeratin to reveal the repair of endometrial epithelium.RESULTS:The thickness of uterine muscle and volume density of actin in M-C group were significantly lower than those in N-O group,but the muscle collagen volume density and defect rate of endometrium were higher than those in N-O group.At the 1st and 4th weeks after treatment with WJMSCs,the muscular thickness and muscular actin concentration in M-T group(A and B)were significantly higher than those in M-C group,while the number of muscular collagen fibers were significantly lower than that in M-C group.The endometrial insufficiency in M-C group was higher than that in the other groups(P<0.05).CONCLUSION:WJMSCs promote the repair o

关 键 词：华通胶 间充质干细胞 子宫切口瘢痕缺陷 肌动蛋白 细胞角蛋白 

分 类 号：R714.4[医药卫生—妇产科学] R363.2[医药卫生—临床医学]