不同组织来源的生物补片修补腹壁肌部分层次缺损的研究

Experimental assessment of tissue repair of basement membrane in partial thickness defect in abdominal wall of rats

目的探讨不同组织来源的生物补片体内组织重塑的差异,并提供信息供临床选择生物补片时参考。方法选取健康SD大鼠,随机分组,每组10处缺损,建腹壁肌部分层次缺损模型并以基底膜(basement membrane,BM)/小肠黏膜下层(small intestine submucosa,SIS)复合细胞外基质补片、SIS补片、真皮补片和心包补片修补,设立未修补组为空白对照。术后2、4、8、16周评价修复区血清肿发生、皱缩率、植入降解比例,取修复区组织做组织学切片分析补片内组织长入、新生血管化、周围组织包裹情况。结果实验期内,BM/SIS复合细胞外基质补片未发生血清肿,基本维持植入面积,术后4周再生高度有序的新生胶原替代缺损区域,术后8周补片降解。术后2周,SIS补片的血清肿发生率为65%,修复区早期大量炎性细胞浸润,再生胶原组织有序性较差,术后8周补片降解,术后16周皱缩率为-52.0%±9.8%。50%的真皮补片细胞浸润补片中央,完全降解。其余真皮补片出现纤维囊包裹,细胞仅浸润交界区,修复区显著扩张,实验期内无降解。心包补片仅少量细胞浸润交界区,无组织长入,术后16周皱缩率为-29.5%±14.0%,出现致密纤维囊包裹,实验期内无降解。结论与SIS补片、心包补片和真皮补片相比,BM/SIS复合细胞外基质补片具备优异的组织修补和再生疗效。

Objective To evaluate the therapeutic effects of biological grafts derived from different tissue,to provide reference information for the clinical choice of biological grafts.Methods Healthy SD rats were randomly divided into 5 groups(n=10).Bilateral partial thickness defect in abdominal wall of rats were created and repaired with either basement membrane(BM)/small intestine submucosa(SIS)composite extracellular matrix(ECM)graft,SIS,dermis or pericardium,while untreated defects were served as control.Animals were sacrificed at 2,4,8 and 16 weeks after surgery,the incidence of seroma,shrinkage in repair area and degradation of implants were recorded.The repaired abdominal walls were harvested for histological evaluation to observe cell ingrowth,neovascularization,and fibrous encapsulation.Results No seroma formation was observed in BM/SIS composite ECM graft repaired samples,and the samples replaced with dense and well-organized collagen fibers with mainly initial dimensions at 4 weeks post-surgery,degraded at 8 weeks post-surgery.There still presents massive inflammatory cells infiltration in SIS repaired area at 4 weeks post-surgery.At 8 weeks post-surgery,seroma incidence in SIS repaired samples was 65%and SIS was degraded.SIS had reconstructed tissue defects with a notable shrinkage rate of-52.0%±9.8%.50%of dermis repaired area was infiltrated by cells and fully degraded.Fibrous encapsulation was formed in other dermis repaired area and cells were only infiltrated in the interface area.Significant enlargement compared with original implant area and no obvious degradation were observed.During the experimental period,scarcely any cells infiltrated the scaffold of pericardium with a shrinkage rate of-29.5%±14.0%at 16 weeks post-surgery.No degradation was observed and fibrous encapsulations were formed in pericardium repaired samples.Conclusion BM composite graft has shown a better tissue regeneration compared with SIS,dermis and pericardium.