CAJ | 학술논문

目的探讨尿道细胞外基质修复尿道创伤缺损的疗效及其组织相容性. 方法实验组20只家兔手术切除一段长约1.0～1.5 cm的尿道,人工造成尿道缺损模型.再用一段等长的尿道细胞外基质修复尿道缺损.另设对照组(仅在游离尿道后关闭切口,10只)和异体尿道移植组(配对互换移植,10只).采用淋巴细胞转化实验及术后1,2,3,4周从兔耳缘静脉取血,应用流式细胞仪检测样本中T淋巴细胞亚群CD4+、CD8+及CD4+/CD8+动态变化,评估术后受体的免疫反应状态;术后10 d、3,6及24周取修复段尿道,行组织学观察;术后24周行尿道造影、尿道镜及尿流动力学检查. 结果实验组术后淋巴细胞刺激指数及外周血淋巴细胞亚群CD4+、CD8+及CD4+/CD8+比值和对照组比较,差异无统计学意义;但异体尿道移植组则高于对照组(P<0.05).术后3周起实验组上皮细胞覆盖细胞外基质的整个管腔;24周尿道平滑肌数量明显增多,接近正常的尿道组织结构.尿道造影及尿道镜检查显示尿道基质管壁光滑通畅.尿流动力学检测显示实验组与对照组比较,差异无统计学意义. 结论尿道细胞外基质具有较好的组织相容性,是一种安全有效的尿道修复材料.
목적 탐토뇨도세포외기질수복뇨도창상결손적료효급기조직상용성. 방법 실험조20지가토수술절제일단장약1.0～1.5 cm적뇨도,인공조성뇨도결손모형.재용일단등장적뇨도세포외기질수복뇨도결손.령설대조조(부재유리뇨도후관폐절구,10지)화이체뇨도이식조(배대호환이식,10지).채용림파세포전화실험급술후1,2,3,4주종토이연정맥취혈,응용류식세포의검측양본중T림파세포아군CD4+、CD8+급CD4+/CD8+동태변화,평고술후수체적면역반응상태;술후10 d、3,6급24주취수복단뇨도,행조직학관찰;술후24주행뇨도조영、뇨도경급뇨류동역학검사. 결과 실험조술후림파세포자격지수급외주혈림파세포아군CD4+、CD8+급CD4+/CD8+비치화대조조비교,차이무통계학의의;단이체뇨도이식조칙고우대조조(P<0.05).술후3주기실험조상피세포복개세포외기질적정개관강;24주뇨도평활기수량명현증다,접근정상적뇨도조직결구.뇨도조영급뇨도경검사현시뇨도기질관벽광활통창.뇨류동역학검측현시실험조여대조조비교,차이무통계학의의. 결론 뇨도세포외기질구유교호적조직상용성,시일충안전유효적뇨도수복재료.
Objective To study the effect and histocompatibility of urethral extracellular matrix in repair of traumatic urethra defects in rabbits. Methods Model of traumatic urethral defects was made by resecting 1.0-1.5 cm segment of the urethra in 20 rabbits. Then, the defects were repaired by a tube of extracellular matrix of the same length. The dynamic changes of CD4+, CD8+ T cell and CD4+/CD8+ in peripheral blood were detected by flow cytometry at 1,2, 3 and 4 weeks after operation. In the meantime, the immunity response of rabbits was evaluated by lymphocyte transformation test. The repaired segments stained with hematoxylin-eosin (HE) and Van Giesen were studied by histologic and pathologic observations at 10 days, 3, 6 and 24 weeks postoperatively. The urodynamics, urethroscopy and urethrography were performed at 24 weeks postoperatively. Results There was no significant difference in aspects of stimulative index of lymphocyte transformation, T lymphocyte subsets CD4+, CD8+ T cell and CD4+/CD8+ between experimental group and negative control group. Urothelium covered the whole surface of the matrix tube three weeks after operation. The smooth muscle cells increased nearly to normal urethral wall at 24 weeks. Urethrosoopy and urethrography showed glossy matrix tube. There was no statistical difference upon urodynamies between experimental group and control group. Conclusion The urethral extracellular matrix has good histocompatibility and may be a safe and effective material for repairing urethra defects.