应用三丙烯微球行子宫动脉栓塞对子宫内膜微血管密度的影响

探讨应用三丙烯微球行子宫动脉栓塞术(UAE)对子宫内膜微血管密度(MVD)的影响。方法 69只健康雌性豚鼠按随机数字法分为对照组(n=12)、UAE组(n=45)及假手术组(n=12);UAE组内再随机分为A1、A2及A3 3个亚组(每组n=15)。UAE组动物应用三丙烯微球行双侧UAE术,术后A1及A2组各死亡1只,最终各入组14只,其余动物生存状态正常。假手术组经子宫动脉注入生理盐水。对照组不做任何处理。各组动物均于排卵期获取子宫标本:A1、A2及A3组动物分别于UAE术后7～15d、16～30 d及31 ～45 d内获取子宫标本;假手术组、对照组于术后16～30 d内获取子宫标本。应用免疫组化法检测各组子宫标本内膜基底层的微血管,计算MVD并进行对比分析。结果 A1、A2组MVD均低于对照组、假手术组(9.64±2.48)条/视野、(14.36±2.73)条/视野比(18.44±3.20)条/视野、(17.63±2.71)条/视野,均P＜0.05];A2组的MVD高于A1组,而A3组的MVD(17.15±2.87)条/视野亦高于A2组(均P＜0.05)。对照组与假手术组、A3组的MVD之间差异并无统计学意义。结论 UAE术后子宫内膜的MVD在一定时期内有所下降,这可能对内膜容受性造成一定程度的负面影响。但随着栓塞后时间延长,MVD数量有逐渐恢复的趋势。

Impact of uterine artery embolization with embosphere on endometrial microvessel density

Objective To explore the impact of uterine artery embolization (UAE) with embosphere on endometrial microvessel density (MVD). Methods Sixty-nine healthy female guinea pigs were randomized into control group (n=12), UAE group (n=45) and sham operation group (n=12). The UAE group was further divided into A1, A2 and A3 subgroups (n=15 each). UAE group underwent bilateral uterine artery embolization with embosphere (trisacryl gelatin microspheres) and eventually, there was 1 death each in A1 and A2 subgroups, such that either subgroup A1 or A2 consisted of 14 animals which were apparently normal. The sham operation group underwent normal saline injection through uterine artery. No procedures were given to the control group. Uterine specimens were obtained during ovulation period:between post-UAE days 7 and 15 from subgroup A1, days 16 and 30 from subgroup A2, days 31 and 45 from subgroup A3, and days 16 and 30 from the sham operation group and control group. The microvessels over the endometrial basal layer were detected by immunohistochemistry, and the MVD was calculated in each group for statistical analysis. Results The MVD in subgroups A1 and A2 was both significantly lower as compared with the control group and sham operation group (9.64 ± 2.48)/field, (14.36 ± 2.73)/field vs (18.44±3.20)/field, (17.63±2.71)/field, all P＜0.05]. The MVD in subgroup A2 was significantly higher than that in subgroup A1 (P＜0.05), but lower than that in subgroup A3 (17.15±2.87)/field (P＜0.05). The MVD in control group did not differ from that in the sham operation group or A3 subgroup. Conclusions The MVD of endometrial basal layer reduces during a certain period of time after UAE, which may have some negative effect on endometrial receptivity. However, the endometrial MVD may gradually resume normal over embolization time.