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目的考察负载重组人基质细胞衍生因子-1α(recombinant human stromal cell-derived factor-1 alpha,rh SDF-1α)的温度敏感性水凝胶PLA/PEG三嵌段聚合物(PLA-PEG-PLA,PLEL)对预防宫腔粘连、促进子宫内膜再生修复的效果。方法 24只成年新西兰雌兔(48条子宫)分为4组(n=12):1自然修复组,纵行剪开子宫全长,剪去子宫内膜,止血后缝合子宫切口;2PLEL治疗组,缝合子宫切口后向宫腔内注射PLEL水凝胶;3PLEL-rh SDF-1α治疗组,缝合子宫切口后向宫腔内注射复合rh SDF-1α的PLEL水凝胶;4假手术组,仅行开腹手术,不处理子宫。分别于术后7 d和28 d取子宫标本,免疫荧光染色观察间质干细胞(mesenchymal stem cells,MSCs)表面标志CD44和CD90的表达,组织学染色观察子宫内膜修复情况。结果自然修复组宫腔粘连,无内膜上皮组织再生。与PLEL治疗组比较,PLEL-rh SDF-1α治疗组有大量MSCs归巢至再生内膜组织(P<0.05),再生内膜上皮层周长/基底层周长比值更大(P<0.05),但均不及假手术组(P<0.05)。结论温度敏感性PLEL水凝胶复合rh SDF-1α具有预防子宫宫腔粘连、促进子宫内膜再生修复的作用。
Objective To investigate the effect of temperature-sensitive hydrogel PLA / PEG triblock polymer loaded with recombinant human stromal cell-derived factor-1 alpha (rh SDF-1α) PLEL) on the prevention of intrauterine adhesions, and promote endometrial regeneration and repair effect. Methods Twenty-four adult New Zealand female rabbits (48 uteri) were divided into 4 groups (n = 12): 1 spontaneous repair group. The length of the uterus was cut longitudinally, the endometrium was cut off and the uterine incision was sutured. , Sutured uterine incision into the intrauterine injection of PLEL hydrogel; 3PLEL-rh SDF-1α treatment group, sutured uterine incision into the intrauterine injection of compound rh SDF-1α PLEL hydrogel; 4 sham operation group, only Open surgery, do not handle the uterus. The uterus specimens were taken on the 7th and 28th postoperative day respectively. The expression of CD44 and CD90 on the surface of mesenchymal stem cells (MSCs) was observed by immunofluorescence staining. The endometrial repair was observed by histological staining. Results Natural repair group intrauterine adhesions, no endometrial epithelial tissue regeneration. Compared with the PLEL-treated group, a large number of MSCs were homing to the regenerated endometrial tissue in the PLEL-rh SDF-1α group (P <0.05), and the ratio of the pericyte / , But not as the sham operation group (P <0.05). Conclusion The temperature-sensitive PLEL hydrogel composite rh SDF-1α can prevent uterine cavity adhesion and promote the repair of endometrium.