应用胶原生物支架结合骨髓间充质干细胞组织工程 - 第三军医大学学报.doc

胶原支架结合骨髓间充质干细胞重建犬膀胱 郭宇，陈伟，贾维胜，马超 ，易善红，叶钢 (400037 重庆，第三军医大学：第二附属医院泌尿外科) ［提要］ 目的 探讨利用胶原支架材料结合骨髓间充质干细胞修复重建膀胱的可行性。方法 制备直径为8.0×8.0cm胶原生物支架结合骨髓间充质干细胞膜片。将15只雄性比格犬随机分为A、B、C三组，A组（n=4）：假手术对照组，B组（n=4）：单纯胶原支架修复组，C组（n=4）：胶原支架结合骨髓间充质干细胞修复组，建立B和C组比格犬膀胱缺损动物模型，分别利用单纯胶原支架材料或结合骨髓间充质干细胞胶原支架修复重建膀胱。各组于修复后23周行静脉肾盂造影、膀胱造影检查及尿动力学检查，均于术后24周对标本取材，并进行大体形态观察及组织学检查，评估膀胱再生情况及功能恢复状态。结果 术后实验组动物均正常生存，拔除尿管自行排尿正常。取材行大体观察发现支架材料均完全降解吸收，未发现膀胱结石、新生物，其中B组1只再生修复部位有明显炎症伴憩室出现，再生区域萎缩现象。尿动力学结果经统计学证实A、C组最大膀胱容量、最大膀胱逼尿肌压、膀胱顺应性差异无统计学意义（P0.05），与B组最大膀胱容量、膀胱顺应性差异有统计学意义（P0.05）。影像学检查除B组2只膀胱造影发现容量过小，其余未见异常。组织学检查提示各实验组粘膜层再生情况均较满意，但其中B组膀胱平滑肌再生明显较C组为差，C组平滑肌层再生尚可但肌纤维排列较对照组稍紊乱。 结论 胶原支架材料结合骨髓间充质干细胞具有良好的促进膀胱组织再生修复能力，这种组织工程方法为最终实现临床重建膀胱的提供了可能。 ［关键词］ 骨髓间充质干细胞；胶原支架；组织工程；膀胱再生；膀胱平滑肌 ［中图法分类号］ R ,R69,694 ［文献标识码］ Application of collagen scaffold combined with bone marrow mesenchymal stem cells to reconstruction canine bladder Guo Yu, Ma Chao, Chen Wei, Jia Weisheng,Ye gang (400037 Chongqing, Third Military Medical University: Department of Urology, Second Affiliated Hospital) ［Abstract］Objective To investigate the use of collagen scaffolds combined mesenchymal stem cells to repair the feasibility of reconstruction of the bladder.method Prepared as 8.0 × 8.0cm in diameter collagen scaffold combined with bone marrow mesenchymal stem cell patch. The 12 male beagle dogs were randomly divided into A, B, C three groups, A group (n = 4): sham operation group, B group (n = 4): collagen scaffold repair group, C group (n = 4 ): collagen scaffold combined with bone marrow mesenchymal stem cells to repair groups. Establish B, C group Beagles bladder defect animal models. Respectively, the use of pure collagen scaffolds or in combination with bone marrow mesenchymal stem cells in collagen scaffolds bladder reconstruction. After 23 weeks, each group in intravenous urography, cystography examination and urodynamic study. Three groups were drawn after 24 weeks on the specimens, and for gross morphology and histology to evalua