膀胱无细胞基质移植物重建同种异体兔膀胱的研究

The dynamic effects of allogenic transplantations with the bladder acellular matrix grafts of rabbits

目的探讨膀胱无细胞基质移植物(BAMG)重建同种异体兔膀胱的效果。方法制备兔BAMG,用一半膀胱大小的BAMG对已行半个膀胱切除的25只同种异体兔做原位移植。8周时测定重建膀胱的容量、压力和顺应性,行膀胱造影;于术后1,2,4,8,12和16周,分别行重建膀胱的光镜和电镜观察。结果同种异体兔膀胱重建术后,肉眼可见BAMG结构上逐渐再生完全。术前与术后8周膀胱最大流出压(Pves,mas)、膀胱最大容量(Volmax)和顺应性(Volmax/Pves,mas)比较,差异均无统计学意义(P均>0·05)。重建膀胱X线造影显示膀胱形态恢复正常。膀胱重建后1周时,在原膀胱和BAMG的交界处有上皮细胞、炎症细胞和毛细血管出现;2周时,BAMG有平滑肌和多层上皮细胞形成;4周后,在BAMG内可见短小的神经,各种成分以BAMG为支架继续再生;16周时,移植的无细胞基质与原膀胱在组织学上无区别。结论应用BAMG重建同种异体兔膀胱后,其结构上和功能上的再生是以BAMG为支架逐步完成的。

Objective To study the dynamic effects of allogenic transplantations with the bladder acellular matrix grafts(BAMG)of rabbits. Methods Hemicystectomies were performed in 25 rabbits, and the defects were repaired with BAMG about half bladder size. The rabbits underwent postoperative assessment of bladder function at 8 weeks, including cystometry, vesical volume, vesical compliance and cystography. The allografts were observed by light microscope and electron microscope at 1, 2, 4, 8, 12, 16 weeks after surgery. Results Macroscopic observation revealed that BAMG regenerated gradually. All urodynamic results of 8 weeks after surgery weren′t different statistically as compared with these of preoperation (P>0.05). Cystography revealed that the morphous of bladder was recovered.Epithelialization and neovascularity occurred accompanied by infiltration of inflammatory cell at 1 week. Smooth muscle cell and stratified epithelium regenerated 2 weeks after grafting. Neural elements formed around smooth muscle bundles as early as 4 weeks.Each component regenerated on the frame of BAMG sequentially.After 16 weeks,it was difficult to delineate the junction between the host bladder and BAMG by histology. Conclusion After allogenic transplantation with rabbits′ BAMG, the constitution and function of the allografts regenerate completely and gradually on the frame of BAMG.