Time limit of human uterine tissue tolerating cold ischemic injury
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摘要:
目的 探讨人类子宫组织耐受冷缺血损伤的时限。 方 法 本文研究材料子宫来自10例因子宫肌瘤行全子宫切除或次全子宫切除的患者。术前所有患者均签署患者知情同意书,符合医学伦理学规定。根据保存液的不同将子宫组织分为两组,分别用0~4℃威斯康星大学(UW)保存液(UW组,5例)和乳酸林格液(乳酸林格液组,5例)保存。达到保存时间后,通过光学显微镜和电子显微镜观察子宫组织学的变化,并观察子宫肌自主收缩和对缩宫素的反应来判断保存组织的冷缺血损伤情况。 结果 所有保存组中子宫内膜和子宫肌层在光学显微镜下均没有改变,而在电镜下,与正常子宫组织比较,UW组保存6、24 h及乳酸林格液组保存6 h的子宫标本超微结构没有明显改变,但在乳酸林格液组保存24 h的样本出现不可逆的退化性改变,子宫组织出现严重的退化性改变,线粒体出现不同程度的肿胀,细胞核出现改变(染色质粗染)。与正常子宫肌相比,所有的保存组中的子宫肌收缩能力均有所减弱。UW组保存6、24 h和乳酸林格液组保存6 h的所有标本出现了自主收缩或在应用小剂量缩宫素后出现收缩,然而,乳酸林格液组保存24 h组无1例出现收缩。 结论 人类子宫组织至少可以耐受6 h的冷缺血损伤,而低温保存在UW液中,至少可以保存24 h。 Abstract:Objective To investigate the time limit of human uterine tissue tolerating cold ischemic injury. Method The uterus in this study were from 10 patients undergoing panhysterectomy or subtotal hysterectomy for hysteromyoma. The informed consents of all patients were obtained and the ethical committee approval was received. According to different preservation solutions, the uterine tissues were divided into University of Wisconsin (UW)solution group (group UW, n=5) and Ringer acetate (RIN) solution group (group RIN, n=5) at 0-4℃. The histological changes of the uterine tissues were observed by optical microscope and electron microscope when time for preservation was up. The autonomic contraction of myometrium and the response of myometrium to oxytocin were observed to judge the cold ischemic injury of the preserved tissues. Result No change in the endometrium and myometrium of all preserved tissues was observed by optical microscope. Compared with the normal uterine tissues, no ultrastructure change of the uterine tissues was observed after 6 h and 24 h storage in UW solution and 6 h storage in RIN solution by electron microscope. But irreversible degenerative changes of the tissues were observed after 24 h storage in RIN solution. Severe degenerative changes of the uterine tissues occurred. Different degree of swelling was observed in the mitochondria and change was also observed in the cell nucleus (thickening chromatin). Compared with normal uterine tissues, all the contraction of myometrium mildly weakened in 2 groups. Autonomic contraction or contraction after applying small dose of oxytocin of all the uterine tissue samples were observed after 6 h and 24 h storage in group UW and 6 h storage in group RIN, while no contraction was observed in samples after 24 h storage in group RIN. Conclusion The human uterine tissue can tolerate cold ischemic injury for at least 6 h and preserve for 24 h in UW solution at low temperature. -
Key words:
- Uterus transplantation /
- Organ preservation /
- Uterus /
- Cold ischemic injury /
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图 1 人类子宫组织在光学显微镜下的病理变化(HE，×400)
注：A图为正常子宫肌层组织，B图为乳酸林格液组保存24 h 的子宫肌层组织，C图为正常子宫内膜组织，D图为乳酸林格液组保存24 h 的子宫内膜组织
Figure 1. Pathological changes of human uterus tissue under optical microscope
图 2 人类子宫组织在电子显微镜下的病理变化(×10 000)
注：A图为正常子宫肌细胞线粒体，B图为乳酸林格液组保存24 h 的子宫肌细胞线粒体，C图为正常子宫肌细胞核，D图为乳酸林格液组保存24 h 的子宫肌细胞核
Figure 2. Pathological changes of human uterus tissue under electron microscope
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