3-D多孔结构的小肠黏膜下组织在兔膀胱再生中的应用

Application of 3-D microporous small intestinal submucosa in bladder regeneration of rabbit model

目的探讨3-D多孔结构的小肠黏膜下组织(small intestine submucosa,SIS)在新西兰大白兔膀胱再生中的应用。方法用物理及化学方法制备具有3-D多孔结构的SIS。将24只雄性新西兰大白兔随机分为3组(n=8),分别行膀胱半切术建立膀胱缺损模型,使用3种不同处理的SIS进行膀胱重建。A组:未经过氧乙酸(peroxyacetic acid,PAA)处理的SIS组;B组:PAA处理的SIS组;C组:PAA处理后100%胎牛血清浸润的SIS组。3组在术前及术后4周测定膀胱容量,并于术后4周取材,行大体观察及组织学检测,评估膀胱再生情况。结果应用SIS行兔膀胱重建术后4周,3组再生膀胱组织与周围组织粘连依次降低,结石率分别为33.3%、28.6%、14.31%。与术前自身比较,术后4周3组膀胱最大容量均缩小且依次增加,组间比较差异有统计学意义(P<0.05)。术后组织学检测示3组膀胱上皮细胞均有再生,与A组比较,B、C组的上皮再生更好,边缘区和中心区无明显差异。3组膀胱平滑肌的再生均不理想,但边缘区平滑肌再生较中心区多;在边缘区和中心区,组间比较差异有统计学意义(P<0.05)。3组在边缘区和中心区的再生血管面积依次增加,3组间比较差异有统计学意义(P<0.05)。结论经PPA及胎牛血清处理后3-D多孔结构的SIS,具有良好的促进膀胱组织再生能力,是一种比较理想的修复支架材料。

Objective To investigate the application of 3-D microporous small intestinal submucosa （SIS） in bladder regeneration of a rabbit model. Methods 3-D microporous SIS was made with physical and chemical method. A total of 24 male New Zealand white rabbits were inflicted with partial cystoplasty and then randomly divided into 3 groups （ n = 8 for each group） and respectively treated with 3 types of SIS for bladder reconstruction. They were group A repaired with treated SIS without peroxyacetic acid （PAA）, group B with PAA treated SIS, and group C with PAA treated SIS and then with 100% fetal bovine serum infiltration. The bladder capacity was measured preoperatively and in 4 weeks postoperatively. Then the rabbits were sacrificed for gross observation and histological examination of bladder in order to evaluate the bladder regeneration. Results In 4 weeks after partial cystoplasty, the tissue adhesion with the surrounding was reduced in turn in groups A, B and C, and the stone formation rate was 33.3% , 28.6% and 14.31% respectively. The bladder capacity was decreased first and then increased in turn in the 3 groups, and significant difference was seen among the 3 groups （P 〈 0.05 ）. Histological observation revealed that urothelial cells were well regenerated in the 3 groups, with those of the groups B and C better than those of group A, and no difference was seen between the marginal zone and the central zone. However, smooth muscle regeneration was not ideal in the 3 groups, but those in the marginal zone were better than the cells in the central zone with significant difference in the groups （P 〈 0.05 ）. The regeneration area of blood vessels were increased in groups A, B and C in turn, and there was statistically significance in the groups （ P 〈 0.05 ）. Conclusion 3-D microporous SIS treated with PAA and fetal bovine serum has ability of promoting the bladder tissue regeneration, and can be regarded as an ideal alternative to repair materials.