摘要
目的：宫腔粘连严重危害女性生殖健康，单纯机械损伤建立动物疾病模型最为接近人类，对开展前瞻性研究非常必要。文中探讨了不同机械损伤方法建立大鼠宫腔粘连模型的效果及意义。方法雌性SD大鼠45只按随机数字表法分为3组：搔刮组（ n＝15），使用直径2 mm刮匙刮取子宫内膜组织；切开缝合组（ n＝15），纵行剖开子宫，刀片刮取子宫内膜组织，可吸收线缝合切口；对照组（ n＝15），假手术开腹，空气暴露20 min后关腹，子宫不处理。通过子宫内膜角蛋白免疫组化染色、宫腔AFS评分、纤维化半定量评分、妊娠结局的观察对比2种造模方法的损伤程度。结果搔刮法或切开缝合法损伤宫腔后，子宫内膜腺上皮角蛋白染色明显减少。搔刮组、切开缝合组AFS评分[3．0（2．0-3．8）分、5．0（3．8-8．0）分]均高于对照组[0（0-0）分]，差异有统计学意义（P＜0．017）；切开缝合组高于搔刮组，但差异无统计学意义（P＞0．017）。搔刮组、切开缝合组子宫内膜纤维化半定量评分[5．0（4．0-5．3）分、6．5（5．8-8．0）分]均高于对照组[0（0-0）分]，差异有统计学意义（P＜0．017）；切开缝合组高于搔刮组，但差异无统计学意义（P＞0．017）。搔刮组及切开缝合组造模侧胚胎数为[0．5（0-3．3）、0（0-2．3）]低于对侧未造模侧[7．6（6．8-8．0）、8．0（7．8-9．0）]，差异有统计学意义（P＜0．05）。结论单纯机械损伤宫腔搔刮法及切开缝合法对于大鼠IUAs造模均可行，2种方法均有助于IUAs发病学及病理生理学机制的研究，切开缝合法造成宫腔内膜纤维化趋势更重。
Objective Intrauterine adhesions cause serious damage to women′s reproductive health, to establish animal disease mode, pure mechanical damage is the most similar cause to human pathogenesis, that is very necessary to conduct prospective studies. The study aimed to investigate the efficiency and significance of different mechanical damage methods to establish intrauterine adhesions model in rats. Methods 45 female SD rats were randomly（ random number table） divided into three groups：pure scratch group （n=15）, 2 mm diameter curet was used to scrape endometrial tissue; Incisionsuture group （n=15）, a longitudinal incision was made in the uterus, a blade was used to scrape endometrial tissue, the incision was then sutured with absorbable thread;Control group （ n=15） , sham operation, then the abdomen was closed after exposed to air for 20 minutes, the uterus were not injured. Endometrial keratin immunohistochemical staining, Intrauterine AFS score, fibrosis semiquantitative score and pregnancy outcomes were observed to compare the injury of the two methods in establishing the model. Results （ 1） The degree of endometrial glandular epithelium keratin staining decreased significantly in both pure scratch and incisionsuture groups compared to the control group. （2） AFS scores in pure scratch group and incisionsuture group[3.0 （2.0-3.8）, 5.0 （3.8-8.0）] were higher than control group[0 （0-0）], the difference was statistically significant （P〈0.017）; Incisionsuture group was higher than pure scratch group, but the difference was not statistically significant（P〉0.017）. Endometrial fibrosis semiquantitative scores in pure scratch group and incisionsuture group[5.0 （4.0-5.3）, 6.5 （5.8-8.0）] were higher than control group[0 （0-0）], the difference was statistically significant （ P〈0.017）;Incisionsuture group was higher than pure scratch group, but the difference was not statistically significant （P〉0.017）. （3） Embryo number in pure scratch and incisionsuture group side [0.5 （0-3.3）, 0 （0-2.3）] was lower than the normal side [7.6 （6.8-8.0）, 8.0 （7.8-9.0）],the difference was statistically significant （P〈0.05） Conclusion Pure mechanical damage including pure scratch and incisionsuture method to establish IUAs model were feasible. Both of the two methods could help to do research about pathogenesis and pathophysiological mechanisms of IUAs. Incisionsuture method maybe can cause heavier fibrosis degree.
出处
《医学研究生学报》
CAS
北大核心
2016年第10期1026-1030,共5页
Journal of Medical Postgraduates
基金
国家科技支撑计划项目(2014BAI05B03)
北京市医院管理局临床医学发展专项(ZYLX201406)
首都卫生发展科研专项项目(2014-1-2112)
关键词
宫腔粘连
机械损伤
纤维化
宫腔搔刮
切开缝合
Intrauterine adhesions
Mechanical damage
Fibrosis
Scratch
Cut open suture
