小鼠腹膜内外不可吸收线结诱导局部早期迟发型超敏反应的组织学研究

Histological study of local early delayed type hypersensitivity induced by intraperitoneal and extraperitoneal nonabsorbable thread knots in mice

目的探索和比较采用两种不可吸收丝线在小鼠腹壁腹膜内、外打结后线结诱导局部早发迟发型超敏反应的差异。方法取7只10~12周BALB/c小鼠,每只腹壁左向右纵向剪开3个腹壁切口(5 mm长),从左向右依次经3个腹壁皮肤切口处采用4-0带针慕斯线荷包缝合腹壁肌深面壁层腹膜后打结于腹膜外间隙(慕斯线腹膜外打结组)、打结于壁腹膜(慕斯线腹腔内打结组),经腹壁切口采用4-0 Proline线荷包缝合腹壁后打结于壁腹膜(Proline线腹膜内打结组)。术后7 d取材3组打结部位腹壁标本。结果免疫组织化学和半定量检测显示,Proline线腹膜内打结组线结周围抗原肽-主要组织相容性复合体(major histocompatibility complex,MHC)Ⅰ/Ⅱ类分子复合物、CD4^(+)、干扰素-γ(interferon-γ,IFN-γ)、淋巴毒素(lymphotoxinβ,LTβ)表达少于慕斯线腹膜外打结组和慕斯线腹腔内打结组,但慕斯线腹膜外打结组和慕斯线腹腔内打结组比较差异无统计学意义。Masson染色结果显示,Proline线腹膜内打结组线结周围可见片状纤维胶原条索,胶原纤维排列相对均一;慕斯线腹膜外打结组和慕斯线腹腔内打结组仅见散在纤维胶原条索,排列松散。结论Proline线较慕斯线诱导小鼠腹壁线结周围早期迟发型超敏反应轻微。腹腔镜监视下闭合内环口时,采用Proline线腹腔内荷包缝合打结较慕斯线腹膜外缝合和腹腔内荷包缝合打结线结超敏反应轻,相对更理想。

Objective To investigate compare the difference of local early delayed type hypersensitivity induced by two kinds of non-absorbable silk suture in intraperitoneal and extraperitoneal abdominal wall of mice.Method Selected 7 Balb/C mice(10-12 weeks),three vertical and parallel incisions with 5 mm length from left to right were created in abdominal wall in each mice,The deep wall of abdominal wall was sutured with 4-0 MERSILK■non-absorbable suture with needle mousse line and knotted in the extraperitoneal space(MERSILK■extraperitoneal knotting group),knotted in the wall peritoneum(MERSILK■intraperitoneal knotting group)and the wall peritoneum was knotted with 4-0 Proline suture through the abdominal wall incision(Proline suture intraperitoneal knotting group).At 7 days after operation,the abdominal wall specimens of the three groups were taken.Result The results of mmunohistochemistry staining and quantitative evaluation showed that the expression of antigen peptide-major histocompatibility complex(MHC)classⅠ/Ⅱmolecules complex,CD4^(+),interferon-γ(IFN-γ)and lymphotoxin-β(LT-β)in the Proline suture intraperitoneal knotting group were less than those in the MERSILK■extraperitoneal knotting group and the MERSILK■intraperitoneal knotting group,However,there was no significant difference between the MERSILK■extraperitoneal knotting group and MERSILK■intraperitoneal knotting group.Masson staining showed that there were flaky fibrous collagen cords around the knot in the Proline suture intraperitoneal knot-tying group,and the collagen fibers were arranged relatively uniformly.In the MERSILK■extraperitoneal knotting group and MERSILK■intraperitoneal knotting group only scattered fibrous collagen cords were observed and arranged loosely.Conclusion Proline■suture knot induces less early delayed hypersensitivity around the abdominal wall knot than MERSILK■silk suture.When the inner ring is closed under laparoscopic monitoring,the use of Proline suture intraperitoneal purse-string suture knot is less hypersensitive than the use of MERSILK■silk sutured and intraperitoneal purse-string suture knot,which is relatively ideal.