人流刮宫与单纯机械损伤构建子宫内膜损伤大鼠模型的评价与比较
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1.广州中医药大学护理学院;2.广东省中山市中医院;3.广州中医药大学第三附属医院

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广州中医药大学校院联合科技创新基金(GZYZS2024U13);广东省自然科学基金面上项目(2024A1515012194)


Evaluation and comparison of rat models of endometrial injury induced by artificial abortion and simple mechanical injury
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1.chool of Nursing, Guangzhou University of Chinese Medicine;2.Zhongshan Hospital of Traditional Chinese Medicine,Guangdong Province;3.the Third Affiliated Hospital of Guangzhou University of Chinese Medicine

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University - Hospital Joint Fund Project of Guangzhou University of Chinese Medicine (GZYZS2024U13); General Program of Guangdong Natural Science(2024A1515012194)

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    摘要:

    目的 对比单纯机械损伤法和人流刮宫法,探索更符合子宫内膜损伤临床病因和疾病特征的动物模型,并探讨妊娠期宫腔操作更易造成损伤的原因。方法 将42只雌性大鼠随机分为3组,即假手术组6只、单纯机械损伤组(S组)18只、人流刮宫组(A组)18只,除假手术组外其余两组分为3个亚组,分别于术后第一、第二、第三动情期取材。HE染色观察子宫内膜组织病理学改变;Masson染色观察子宫内膜纤维化程度;免疫组化检测大鼠子宫组织CD31、LIF表达情况;免疫荧光检测子宫内膜CD68表达情况。ELISA检测大鼠血清炎性因子及激素水平,Western blotting检测大鼠子宫内膜组织CD68、CD86、TGF-β蛋白表达。结果 (1)术后第三个动情期时,单纯机械损伤组大鼠子宫病理形态变化较小,子宫内膜厚度、上皮细胞及巨噬细胞变化、炎症水平较假手术组无显著性差异,仅纤维化水平和血管再生能力符合子宫内膜损伤临床特征。而人流刮宫组大鼠子宫内膜变薄,腺体数目减少,腔上皮细胞显著减少,巨噬细胞表达增加并伴有明显的炎症反应,子宫纤维化水平大幅增加,血管再生能力下降,四个维度均符合临床特征。(2)两种方法造模后大鼠子宫内膜纤维化水平可随损伤时间增加而增长,血清炎性因子水平随损伤时间增加而减少,但人流刮宫大鼠炎性因子水平下降更缓慢,炎症反应持续时间更长。结论 人流刮宫造模更符合现阶段对人类子宫内膜损伤临床病因和疾病特征的认识,且妊娠期宫腔操作更易损伤的原因可能与巨噬细胞持续高表达导致子宫内膜处于慢性炎症状态有关。

    Abstract:

    Objective Compared with the simple mechanical injury method and the artificial abortion mechanical injury method, to explore the animal model which is more in line with the clinical etiology and disease characteristics of endometrial injury,and to explore the reasons why intrauterine operation during pregnancy is more likely to cause injury. Methods 42 female rats were randomly divided into 3 groups: Sham operation group(N=6) , simple mechanical injury group(N=18), and artificial abortion injury group(N=18), except for the Group Sham, the other two groups were divided into 3 subgroups, which were taken in the first, second and third estrous period after operation. The histopathology changes of endometrium were observed by HE staining, the degree of endometrial fibrosis was observed by Masson staining, and the expression of CD31 and LIF in rat uterine tissue was detected by immunohistochemistry The expression of CD68 in endometrium was detected by immunofluorescence. Serum levels of inflammatory factors and hormones were measured by ELISA, and the expression of CD68, CD86 and TGF-β in endometrium was detected by Western blot.Results (1) in the third estrous phase after surgery, the pathological changes of the uterus in Group S were small, and the changes of endometrial thickness, epithelial cells and macrophages were not significant, there was no significant difference in the level of inflammation between the Group S and Group Sham. Only the level of fibrosis and the ability of vascular regeneration were consistent with the clinical characteristics of endometrial injury. However, in the Group A, the endometrium became thinner, the number of glands decreased, the luminal epithelial cells decreased significantly, the expression of macrophages increased and was accompanied by obvious inflammatory response, and the level of uterine fibrosis increased significantly, the ability of vascular regeneration was decreased. Four dimensions were in line with the clinical characteristics. (2) the level of endometrial fibrosis increased with the increase of injury time, and the level of serum inflammatory factors decreased with the increase of injury time, however, the level of inflammatory factors decreased more slowly and the inflammatory reaction lasted longer in rats with artificial abortion and mechanical injury.Conclusion the artificial abortion injury model is more in line with the current understanding of the clinical etiology and disease characteristics of human endometrial injury, the reason why the uterine cavity operation during pregnancy is more vulnerable to injury may be related to the sustained high expression of macrophages, which leads to the chronic inflammation of the endometrium.

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  • 收稿日期:2025-07-18
  • 最后修改日期:2026-01-09
  • 录用日期:2026-01-30
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