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目的:研究聚乳酸-羟基乙酸共聚物[poly(lactic-co-glycolic acid),PLGA]膜作为生物可降解材料用于预防宫腔粘连的可行性初步研究。方法:制备不同单体比例的PLGA膜,分别于模拟宫腔液以及昆明小鼠宫腔中进行体外和体内降解实验。将30只昆明小鼠随机分为假手术组、宫腔粘连组、PLGA膜组,每组各10只,运用Masson染色和Western blot观察各组昆明小鼠子宫内膜纤维化程度和相关蛋白的表达。结果:不同单体比例的PLGA膜体外降解时间不同,PLGA膜(50∶50)的降解速度最快,在4周时质量损失达98.5%;PLGA膜(90∶10)降解速度最慢,在12周时其质量损失仅为7.8%;PLGA(75∶25)降解速度介于前两者之间,于12周时质量损失达95.7%。不同单体比例的PLGA膜体内降解时间不同,PLGA膜(50∶50)7 d后在宫腔内完全降解,而PLGA膜(75∶25)、PLGA膜(90∶10)仍然滞留于宫腔中。与假手术组相比,PLGA膜组(75∶25)增加了昆明小鼠子宫内膜纤维化面积(P=0.000)以及相关蛋白的表达(P<0.01);与宫腔粘连组相比,PLGA膜组(75∶25)子宫内膜纤维化面积以及相关蛋白的表达无明显差异(P>0.05)。结论:PLGA生物可降解材料用于预防宫腔粘连,具有宫腔内降解速度可调节、不增加宫腔粘连组子宫内膜纤维化程度的特点,在预防宫腔粘连方面具有潜在的应用价值。
OBJECTIVE: To study the feasibility of using poly (lactic-co-glycolic acid) (PLGA) as a biodegradable material for the prevention of intrauterine adhesions. Methods: PLGA membranes with different monomer ratios were prepared and tested in vitro and in vivo in simulated uterine fluid and Kunming mouse uterine cavity respectively. 30 Kunming mice were randomly divided into sham operation group, intrauterine adhesion group and PLGA membrane group, each group had 10 rats. Masson staining and Western blot were used to observe the degree of endometrial fibrosis and related proteins in Kunming mice expression. Results: The degradation rate of PLGA membrane was the fastest at 50:50 with 98.5% loss at 4 weeks. The degradation rate of PLGA membrane at 90:10 was the lowest At 12 weeks, the mass loss was only 7.8%. The degradation rate of PLGA (75:25) was between the first two and the mass loss was 95.7% at 12 weeks. PLGA membranes with different monomer ratios showed different degradation time in vivo. PLGA membrane (50:50) completely degraded in uterine cavity after PLGA membrane (75:25) and PLGA membrane (90:10) remained in the uterine cavity in. PLGA membrane group (75:25) increased the area of endometrial fibrosis (P = 0.000) and the expression of related proteins (P <0.01) in Kunming mice compared with sham operation group. Compared with the control group, The area of endometrial fibrosis and the expression of related protein in PLGA membrane group (75:25) had no significant difference (P> 0.05). Conclusion: PLGA biodegradable materials for the prevention of intrauterine adhesions with intrauterine degradation rate can be adjusted without increasing intrauterine adhesions group of endometrial fibrosis degree of features, in the prevention of intrauterine adhesions has potential applications.