血管内皮生长因子单克隆抗体治疗子宫内膜异位症的实验研究

目的：观察血管内皮生长因子（VEGF）单克隆抗体（单抗）对子宫内膜异位症（EMs）血管生成的抑制作用，为从抗血管途径治疗EMs提供依据。方法：60只新鲜受精鸡蛋随机分为接种组（20枚）、接种治疗组（20枚）、单纯空白组（10枚）和空白载体组（10枚）。接种组和接种治疗组建立子宫内膜异位症鸡胚绒毛尿囊膜（CAM）模型，接种治疗组给予VEGF单抗10μg/d。单纯空白组不接种子宫内膜，空白载体组以无菌明胶海绵为载体，给予PBS20μg/d。通过显微血管计数、原位铺片及组织学观察等方法检测接种的子宫内膜组织对CAM血管生成和VEGF单抗对异位内膜病灶生长行为的影响。结果：接种组CAM血管生成反应明显增强，血管数目显著高于单纯空白组和空白载体组；接种治疗组血管数目显著低于接种组，有明显的间质坏死。结论：子宫内膜能明显促进CAM的血管生成，VEGF单抗能够显著抑制异位病灶的血管形成，并抑制子宫内膜的生长，证实抗血管途径可以作为治疗EMs的一种有效方法。

Effect of monoclonal antibody against vascular endothelial growth factor on endometriosis-like lesions in the chick embryo chorioallantoic membrane:an experimental study

Objective： To investigate the effect of monoclonal antibody against vascular endothelial growth factor （VEGF） on angiogenesis in endometriosis, in order to lay a theoretical foundation for the treatment of endometriosis. Methods： Sixty fresh impregnated eggs were randomly divided into 4 groups： transplantation group（n=20）, transplantation and treatment group （n=20）, blank group （n=10）, and vector group（n=10）. In transplantation group, eutopic endometriurn from endometriosis was transplanted to the non-vascular region of the chick embryo chorioallantoic membrane （CAM）. Monoclonal antibody against VEGF in a dose of 10 μg/d was given to transplantation and treatment group. Endometrium was not implantated in blank group, and 20μg/L phosphate buffer was given in vector （bacteria free gelatin sponge） group with the vector of axemic glutin sponge. Vascularization and endometriosis-like lesion formation were studied by counting the number of blood vessels and histological study. Results： Transplantation of endometrium onto the CAM fed to a strong angiogenic response in the chicken embryo. The number of newly formed vessels was significantly increased in the transplantation group as compared with the blank group and vector group. Endometriosis-like lesion formation was significantly inhibited after treatment with monoclonal antibody against VEGF, and light microscopy showed necrosis in the endometriosis-like lesions. Conclusion： Endometrium implantation can induce angiogenic response in the ectopic environment, and monoclonal antibody against VEGF can inhibit the angiogenesis hence has a remarkable anti- endometriosis effect.