不同气腹压力对子宫内膜异位症模型异位病灶超微结构的影响

Effects of CO_2 Pneumoperitoneum with Various Pressures on the Ultrastructure of the Implanted Lesions in Endometriosis Models

目的观察不同气腹压力对大鼠子宫内膜异位症模型异位病灶超微结构的影响。方法SD大鼠子宫内膜腹膜自体移植制成子宫内膜异位症模型,造模成功后随机分为对照组、10mmHg气腹组和20mmHg气腹组(每组10只),作用时间1h,手术结束后1周取子宫内膜异位灶行电镜检查,观察异位病灶腺上皮细胞凋亡和其他细胞器超微结构改变。结果对照组异位灶腺细胞结构良好,基质细胞排列整齐,微绒毛正常。10mmHg和20mmHg气腹组均有异位灶腺细胞染色质边集,线粒体嵴消失,线粒体肿胀明显;微绒毛减少或消失,细胞连接缝隙增宽断裂,基底层细胞排列紊乱。与10mmHg比较,20mmHg气腹组异位灶各细胞器受损程度相对严重。结论CO2气腹可导致子宫内膜异位灶细胞超微结构破坏,20mmHg气腹组对其损伤作用大于10mmHg组。

Objective To evaluate the effect of CO2 pneumoperitoneum with various pressures on the ultrastructure of the implanted lesions in rats model of endometriosis. Methods Endometriosis model was established in 30 SD rats by implanting self-endometria onto the peritoneum to form ectopic endometrial tissues. Then the animals were divided randomly into three groups （ten in each）：control,10 mm Hg,and 20 mm Hg CO2 pneumoperitoneum groups （CO2 inflation lasted for 1 hour）. One week after the procedure,the ectopic endometrial tissues were sampled for electron microscopy to determine the ultrastructure of cell organelle in the endometriosis glands and matrix cells. Results The electron microscopy showed that in the control group,the matrix cells lined up in order and the structure of the microvilli （MV） was normal, while in the 10 mm Hg and 20 mm Hg groups,the chromatin margination of glandular cells and mitochondria swelling were observed with reduced or vanished mitochondrial crista,the ultrastructural damages to the microvilli （reduced or vanished） were more apparent than the control,the cell junctions were widened or collapsed,and the matrix cells lined up disorderly. Compared to the 10 mm Hg group,ultrastructural damage to the glandular cells in the 20 mm Hg group was more severe. Conclusions CO2 pneumoperitoneum intervention can induce ultrastructural damage to endometriosis lesions. 20 mm Hg pressure of CO2 pneumoperitoneum can induce severer damage to the ectopic endometriosis tissues than 10 mm Hg.