子宫内膜异位症猕猴动物模型的建立

Establishment of animal models of endometriosis in rhesus monkeys

目的构建子宫内膜异位症(EM)猕猴动物模型.方法选择5只健康、月经规律的雌性猕猴(4只实验猴、1只对照猴),在月经第8～15天,雌激素高峰的第3～5天,手术将猕猴的子宫内膜种植到盆腔子宫腔以外的部位,对照猕猴用大网膜取代内膜种植.在术后第2、4个月动物月经周期的第8～15天开腹或腹腔镜探查.结果术后第2个月探查,4只实验猴中,3只异位内膜种植存活,其中2只形成异位囊肿.术后第4个月,对2只已形成EM的猕猴行腹腔镜再次探查,其盆腔粘连,异位内膜生长情况与术后第2个月基本相似;3只形成EM的猕猴精神状态、饮食、体质量增长情况均较对照猕猴差,2只发生肠套叠死亡.结论本研究根据种植学说原理成功地构建了子宫内膜异位症猕猴动物模型,但猕猴的个体差异是模型是否成功的一个关键因素,因而认为遗传因素是子宫内膜异位症发病中的另一重要机制,子宫内膜异位生长对机体的整体机能有较为明显的影响.

Objective To establish animal models of endometriosis in rhesus monkeys and study the invasion mechanism of endometriosis. Methods Five female healthy rhesus monkeys with regular menstrual cycles were selected, of whom 4 were used for endometriosis model establishment and 1 for control. During the period of days 8-15 of menstruation, or 3-5 days after the midcycle estrogen peak, the endometrium was implanted into the pelvic cavity other than the uterus in the experimental group, and in the control group, the greater omentum was implanted instead. Exploratory laparotomy or laparos- copy was performed during the period between days 8 and 15 of menstruation in the second and the fourth month respectively after the implantation for observing the occurrence of endometriosis. Results In the experimental group, the implanted endo- metrium survived in the receptor site in 3 monkeys, 2 of whom were found to have chocolate cyst after the operation. Laparoscopy was again performed in the 2 monkeys with endometriosis 4 months after the operation, showing pelvic adhesion and growth of ectopic endometrium similar to the changes as observed two months after the operation. In comparison with the control, deteriorated mental states and dietary changes, along with body weight losses, occurred in the 3 models of endometriosis, and 2 of them later died of intussusception. Conclusions Animal models of endometriosis can be established successfully in rhesus monkeys on the basis of the implantation theory, which, however, is influenced by individual differences between the animals. Heredity is an important factor in pathogenesis of endometriosis, and ectopic growth of the endometrium may severely impact the body function.