大鼠子宫腔粘连模型的构建与改进

A rat model of intrauterine adhesion established by endometrial scraping

目的宫腔粘连是一种严重损害女性生殖健康的疾病。为了进一步研究宫腔粘连的发生机制,采用经典的子宫内膜刮除法制作宫腔粘连大鼠模型,并对该模型进行评价和改进。方法 60只SD大鼠随机分为3组:假手术组、子宫内膜刮除组和子宫内膜及部分间质刮除组,每组20只。假手术组打开宫腔后即缝合并关腹。子宫内膜刮除组用刀片刮除双侧子宫内膜。子宫内膜及部分间质刮除组用刀片刮除双侧子宫内膜和间质层,直至表面有粗糙感为止。术后3、7、14、21、28 d取材,行组织学和免疫组织化学评估。结果刮宫后两组大鼠子宫内膜上皮层消失,子宫内膜刮除组大鼠术后7 d可发现重新长出的子宫内膜。而子宫内膜和部分间质刮除组大鼠各时间点组织学染色见上皮层消失,间质减少50%以上,腺体数目减少,子宫内膜纤维化面积比随着刮宫时间延长而增高。刮宫后转化生长因子β1的表达增高,基质金属蛋白酶9的表达降低。与宫腔粘连发生的机制相符。结论刮除子宫内膜和部分间质能够制备出大鼠宫腔粘连的模型;该宫腔粘连大鼠模型能反映宫腔粘连的组织学和病理学变化,可用于宫腔粘连的实验研究。

Objective Intrauterine adhesion(IUA) seriously affects reproductive health of women.In order to better study IUA,we established a rat model of IUA by endometrial scraping,and evaluated the method of this model.Methods A total of 60 SD rats were randomly divided into three groups:the sham group,the endometrial layer scraped group and the endometrial and partly mesenchymal layer scraped group(n=20 each).In the sham group,uteri were cut open and then closed without any other surgical procedures.In the other two groups,endometrial and mesenchymal layers of rats were scraped and sutured.After 3,7,14,21 and 28 days of scraping,uteri were sampled for histological and immunochemical evaluation.Results The endometrial layer of uteri was disappeared.The new endometrial layer of uteri was seen in the endometrial layer scraped group after 7 days of scraping.In the endometrial and partly mesenchymal layer scraped group,folds of endometrium were absent,the endometrial layer was removed,at least 50% of mesenchymal layer was disappeared,the number of endometrial glands were significantly decreased,and the fibrosis area of endometrium was increased with the development of fibrosis.The expression of transforming growth factor β1 was increased while matrix metalloproteinase 9 was decreased,which was in accordance with pathophysiological changes.Conclusion Endometrial and partly mesenchymal layer scraping can establish an IUA rat model.The IUA rat model is in agreement with IUA changes,which can be used in IUA studies.