CAJ | 학술논문

目的比较分析骨髓间充质干细胞(bone marrow mesenchymal stem cells,BMSC)与尿道上皮细胞作为种子细胞在尿道组织工程构建中的应用效果,为尿道组织工程构建的种子细胞筛选提供依据.方法分别体外培养兔BMSC及同种异体尿路上皮细胞,5-溴脱氧尿嘧啶核苷(BrdU)标记后接种至人真皮脱细胞基质.然后将体外构建的复合材料分别移植到尿道缺损动物模型体内,分别设为实验组A(BMSC组)和实验组B(尿路上皮组).此外,将无细胞组(单纯的基质材料移植到尿道缺损处)作为对照组(C组).于术后第1、2、4、12周分别采集尿道组织标本,行组织学观察.术后12周对实验动物行逆行膀胱尿道造影检查.结果第1周,A、B组均可见稀疏的单层上皮样细胞覆盖,但A组细胞形状较尿路上皮细胞组欠规则.第2周,A、B组仍是单层尿道上皮覆盖,但A组上皮细胞的致密度较差.第4周,A、B组上皮细胞分布与正常组织较接近,但BMSC组细胞分层较差.第12周,A、B组新生尿道与正常组织已无明显区分.4个观察点中,对照组的修复效果均比实验组差:A组术后并发症发生率为7.14％(2/28),B组为10.71％(3/28),C组为41.67％(5/12).A组术前及术后12周排尿期最大尿道压检测值分别为(24.7±2.0)cmH2O和(25.3±2.1)cmH2O,B组分别为(25.1 ±2.3)cmH2O和(26.1±1.8)cmH2O,C组分别为(24.6±1.9) cmH2O和(33.1±4.5)cmH2O.A、B两组手术前后最大尿道压比较,差异没有统计学意义(P＞0.05);而C组手术前后最大尿道压比较,差异有统计学意义(P＜0.05).结论 BMSC或尿路上皮细胞复合脱细胞外基质移植到机体内均可有效修复尿道缺损;接种至第4周,发现尿路上皮细胞复合脱细胞基质材料修复尿道效果较BMSC好.
목적 비교분석골수간충질간세포(bone marrow mesenchymal stem cells,BMSC)여뇨도상피세포작위충자세포재뇨도조직공정구건중적응용효과,위뇨도조직공정구건적충자세포사선제공의거.방법 분별체외배양토BMSC급동충이체뇨로상피세포,5-추탈양뇨밀정핵감(BrdU)표기후접충지인진피탈세포기질.연후장체외구건적복합재료분별이식도뇨도결손동물모형체내,분별설위실험조A(BMSC조)화실험조B(뇨로상피조).차외,장무세포조(단순적기질재료이식도뇨도결손처)작위대조조(C조).우술후제1、2、4、12주분별채집뇨도조직표본,행조직학관찰.술후12주대실험동물행역행방광뇨도조영검사.결과 제1주,A、B조균가견희소적단층상피양세포복개,단A조세포형상교뇨로상피세포조흠규칙.제2주,A、B조잉시단층뇨도상피복개,단A조상피세포적치밀도교차.제4주,A、B조상피세포분포여정상조직교접근,단BMSC조세포분층교차.제12주,A、B조신생뇨도여정상조직이무명현구분.4개관찰점중,대조조적수복효과균비실험조차:A조술후병발증발생솔위7.14％(2/28),B조위10.71％(3/28),C조위41.67％(5/12).A조술전급술후12주배뇨기최대뇨도압검측치분별위(24.7±2.0)cmH2O화(25.3±2.1)cmH2O,B조분별위(25.1 ±2.3)cmH2O화(26.1±1.8)cmH2O,C조분별위(24.6±1.9) cmH2O화(33.1±4.5)cmH2O.A、B량조수술전후최대뇨도압비교,차이몰유통계학의의(P＞0.05);이C조수술전후최대뇨도압비교,차이유통계학의의(P＜0.05).결론 BMSC혹뇨로상피세포복합탈세포외기질이식도궤체내균가유효수복뇨도결손;접충지제4주,발현뇨로상피세포복합탈세포기질재료수복뇨도효과교BMSC호.
Objective To compare the uses of bone marrow mesenchymal stem cells (BMSC) and urothelium cells in urethral reconstruction and provide theoretical rationales for selecting urethral tissue engineering seed cells.Methods In experimental groups,we separated and cultured rabbit BMSC (group A) and urothelial cells (group B) in vitro and then seeded the cells labeled with bromodeoxyuridine in acellular extracellular matrix.The composite matrix was planted into urethral segment of male rabbits.And urethral defect was repaired with acellular extracellular matrix in control group (group C).Then urethral regeneration was observed at 1,2,4,12 weeks postoperation respectively and the effects of reconstruction were evaluated by urethrography at 12 weeks.Results At 1 week,two experimental groups formed thin layer urothelium on repaired region.However,the cells of group A were less regularly arrayed than those of group B.At 2 weeks,two experimental groups were still covered by single urothelium cells,yet group B had a greater density of urothelium.At 4 weeks,the urothelium of two experimental groups was almost normal and the distribution of group A was better than that of group B.At 12 weeks,urothelium distribution in repaired region of each group was almost normal.And the effects of experimental groups were better than that of group C at all four observation sites.In group A,the postoperative rate of complications was 7.14％(2/28) ;group B 10.71％(3/28); group C 41.67％ (5/12).Groups A and B were more effectively repaired than group C.The urethral pressure of preoperation and 12-week postoperation in group A was (24.7 ± 2.0) vs (25.3 ± 2.1) cmH2O(P＞0.05) ; group B (25.1 ± 2.3) vs (26.1 ± 1.8) cmH2O(P＞0.05) and group C (24.6 ± 1.9) vs (33.1 ± 4.5) cmH2O(P＜0.05).Conclusions Both BMSC and urothelial cells seeded on acellular extracellular matrix can effectively repair urethral defect.Until Week 4 postrepairing,the effect of repair by urothelial cells-acellular extracellular matrix is better than that of BMSC.