摘要目的 探讨以膀胱无细胞基质为细胞载体的无细胞基质组织工程膀胱作为膀胱替代材料的可行性.方法 采用叠氮钠、DNase、PBS反复振荡洗涤膀胱组织,形成膀胱无细胞基质.自8只杂交长风白猪手术获取小块膀胱组织,分离出膀胱平滑肌细胞、移行上皮细胞培养、增殖,将增殖的两种细胞种植于膀胱尢细胞基质两面,共培养后回植,大面积替代自体猪的部分膀胱.分别观察1个月(2只)、3个月(3只)、6个月(3只)后处死,HE免疫组化观察替代部分膀胱组织结构,组织浴槽巾研究无细胞基质组织工程膀胱肌条的体外功能情况.结果 无细胞基质中已无细胞成分残留,培养的膀胱细胞可粘附于无细胞基质并生长.细胞-无细胞基质复合物替代膀胱后,3个月、6个月组均见替代处完整的移行上皮细胞覆盖于腔面,其下膀胱肌层形成,均排列良好,与正常膀胱组织无明显区别.组织浴槽研究提示无细胞基质组织工程膀胱肌条具有与正常膀胱肌条相似的体外功能.结论 无细胞基质组织工程膀胱技术有望为临床提供可行的替代材料来源.

abstractsObjective We investigated the possibility of using bladder acellular matrix seeded with bladder smooth muscle cells and transitional cells as a material for partial bladder replacement. Methods The allogenic bladder acellular matrix was prepared by thorough washing with sodium az-ide, DNAse, and phosphate buffered saline. Small pieces of bladder tissue were collected surgically from 8 pigs. Both bladder smooth muscle cells and transitional cells were harvested and cultured separately in the eight pigs. The allogenic bladder acellular matrixes were then seeded with bladder smooth muscle cells on one side and transitional cells on the opposite side. Partial bladder replacements were per-formed separately with the allogenic bladder acellular matrix seeded with cells. The augmented bladders were retrieved 1,3 and 6 months after replacement operation. Hematoxylin and eosin and immuno-chemical staining were carried out to evaluate the histology of the augmented bladder. The ex vivo function of muscle strips taken from augmented bladder were evaluate by the organ bath study. Results No cell was detected with HE staining and scanning electromicroscopy in the allogenic bladder acel-lular matrix. The cultured bladder cells can adhere to bladder submucosa acelluler matrix and grow in it. Histologically, 3 and 6 months after replacement operation, the retrieved bladder contained a normal cellular organization consisting of transitional cells lined lumen surrounded by smooth muscle.. The or-gan bath study showed that the ex vivo function of muscle strips taken from augmented bladder were similar to the normal bladder muscle strips. Conclusions The allogenic bladder acellular matrix seeded with bladder cells appears to be a viable option as a biomaterial for bladder augmentaion.