CAJ | 학술논문

目的探讨去细胞犬喉支架的性质及其在同种异体犬胸肌内存活的可行性.方法实验组18个供体喉应用十二烷基磺酸钠行去细胞处理,3个用于组织学等检测,15个埋在受体犬胸肌内；对照组供体喉不去细胞,余实验步骤同实验组.两受体组于2周、1个月、2个月各处死5只犬,行大体观察、组织学检查及台盼蓝染色.结果对照组的新鲜喉埋植后缩小甚至消失,与实验组比较采用最小显著差异t检验差异有统计学意义(P＜0.05).实验组去细胞喉支架埋植2周时显微镜观察支架周围仅有少量中性粒细胞及淋巴细胞浸润,1个月后支架周围疏松结缔组织开始形成,2个月时结缔组织明显增厚,血管数量明显增多.对照组埋植2周时大量淋巴细胞及中性粒细胞浸润,1个月时软骨膜被破坏,2个月时软骨细胞消失.埋植前实验组与对照组软骨细胞平均((x)±s,下同)存活率分别为86.8％±3.2％和88.6％±3.1％,采用卡方检验差异无统计学意义(x2=0.19,P＞0.05)；埋植2周和1个月后实验组软骨细胞存活率下降不多而对照组逐渐下降明显,差异均有统计学意义(x2分别为5.52和20.55,P值分别＜0.05和＜0.01)；2个月时实验组存活率为65.8％±2.6％,而对照组软骨细胞全部消失.结论去细胞方法可得到低免疫原性的去细胞喉支架,该支架能够在胸肌包裹下存活,并建立血供,有可能用做全喉重建的生物支架材料.
목적 탐토거세포견후지가적성질급기재동충이체견흉기내존활적가행성.방법 실험조18개공체후응용십이완기광산납행거세포처리,3개용우조직학등검측,15개매재수체견흉기내；대조조공체후불거세포,여실험보취동실험조.량수체조우2주、1개월、2개월각처사5지견,행대체관찰、조직학검사급태반람염색.결과 대조조적신선후매식후축소심지소실,여실험조비교채용최소현저차이t검험차이유통계학의의(P＜0.05).실험조거세포후지가매식2주시현미경관찰지가주위부유소량중성립세포급림파세포침윤,1개월후지가주위소송결체조직개시형성,2개월시결체조직명현증후,혈관수량명현증다.대조조매식2주시대량림파세포급중성립세포침윤,1개월시연골막피파배,2개월시연골세포소실.매식전실험조여대조조연골세포평균((x)±s,하동)존활솔분별위86.8％±3.2％화88.6％±3.1％,채용잡방검험차이무통계학의의(x2=0.19,P＞0.05)；매식2주화1개월후실험조연골세포존활솔하강불다이대조조축점하강명현,차이균유통계학의의(x2분별위5.52화20.55,P치분별＜0.05화＜0.01)；2개월시실험조존활솔위65.8％±2.6％,이대조조연골세포전부소실.결론 거세포방법가득도저면역원성적거세포후지가,해지가능구재흉기포과하존활,병건립혈공,유가능용주전후중건적생물지가재료.
Objective To explore the survivorship and character of decellularized laryngeal scaffold in pectoralis major muscle flap in canine.Methods Eighteen donor larynxes in experimental group were decellularized by perfusing sodium dodecyl sulphate.Three of them were used to detect the character of histology.The other fifteen ones were embedded in right pectoralis major muscle flap of acceptor canine.Donor larynxes in control group were not perfused.Other experimental procedure was the same as experimental group.The specimens were harvested at two weeks,one month and two months after operation,respectively.Macroscopic view,histological examination and trypan blue staining were performed in the experimental group and control group.Results The size of the specimens decreased remarkably into disappearance in control group,there was statistical significance betwwn the experimental group and the control group (which used least significant difference t test P ＜ 0.05).There was only little neutrophils and lymphocytes infiltrating around the laryngeal scaffold at 2 weeks in the experimental group.One month after operation,loose connective tissue begin to form aound the laryngeal scaffold.After two months of transplation,the connective tissue became thicker and the number of blood vessels increased than before.There was a large number of lymphocytes and neutrophil infiltration around the laryngeal specimens in the control group at 2nd week.The perichondrium in the control group was damaged at one month post operation.The cartilage cells could not be detected two months after surgery.The survival rate of cartilage cell between experimental group (86.8％ ±3.2％) and the control group (88.6％ ±3.1％) did not show statistical significance before implantation (x2 =0.19,P ＞ 0.05).The survival rate of cartilage cell decreased insignificantly in experimental group while the survival rate declined obviously in the control group at two weeks and one month after operation,the difference had statistical significance (x2 were respectively 5.52 and 20.55,P were respectively ＜ 0.05 and ＜ 0.01),the survival rate of cartilage cell in experimental group was (65.8％ ± 2.6％) at two months after operation,while the cartilage cell all disappeared in control group.Conclusions Perfused decellularation technique can construct a low immunogenicity laryngeal cartilage scaffold which can survive in the chest muscle package and establish a good blood supplement.The decellularized laryngeal scaffold could be used as a biological scaffold for whole laryngeal reconstruction.