de Almeida Sílvio Henrique Maia, Rodrigues Marco Aurélio Freitas, Gregório Emerson, Crespígio Jéferson, Moreira Horácio Alvarenga
Discipline of Urology, State University of Londrina, Rua Francisco Marcelino da Silva, Londrina, Brazil.
Int J Urol. 2007 Nov;14(11):1040-3. doi: 10.1111/j.1442-2042.2007.01888.x.
Compare inflammation and collagen production induced by four sling materials in female rats.
Adult female rats (n=144) were submitted to a urinary incontinence model and neutering. After four weeks they were randomized in 5 groups: Sham; autologous sling; Marlex; swine intestinal submucosa (SIS), and polypropylene mesh (TVT). Animals were killed at 7, 30 and 90 days. The inflammatory infiltrated area was rated from 0 to 3 (0=area smaller than 25%, 1=between 25% and 50%, 2 between 50% and 75%, and 3 for areas greater than 75%). The presence of granuloma and necrosis was noted. Penetration in the vesical wall was evaluated employing a system of scores from 0 to 3. The amount of collagen I and III, and the total was assessed using the Picro-Sirius staining technique.
The Sham group presented lower inflammatory parameters at 7 days. On the 30th day, the autologous fascia presented inflammatory reactions similar to the Sham group, and lower than the remaining groups. The synthetic materials demonstrated greater inflammatory reactions at 60 days. No differences between groups were observed other than those concerning collagen production, except at 60 days, when TVT and SIS differed from Fascia and Sham in the production of collagen III.
Autologous fascia produced less inflammatory reaction and collagen. TVT and Marlex caused more intense and longer-lasting inflammatory reaction with greater visceral penetration. When TVT was used, this process resulted in a higher quantity of collagen III. The presence of SIS, although presenting a less intense inflammatory reaction than the synthetics, also caused greater collagen III production at 60 days.
比较四种吊带材料在雌性大鼠体内引起的炎症反应和胶原蛋白生成情况。
将成年雌性大鼠（n = 144）制成尿失禁模型并进行绝育。四周后，将它们随机分为五组：假手术组；自体吊带组；Marlex组；猪小肠黏膜下层（SIS）组和聚丙烯网片（TVT）组。在第7天、30天和90天时处死动物。炎症浸润面积按0至3级进行评分（0级=面积小于25%，1级=25%至50%之间，2级=50%至75%之间，3级=面积大于75%）。记录肉芽肿和坏死的存在情况。采用0至3分制评估膀胱壁的穿透情况。使用天狼星红苦味酸染色技术评估I型和III型胶原蛋白的含量以及总量。
假手术组在第7天时炎症参数较低。在第30天时，自体筋膜的炎症反应与假手术组相似，且低于其余各组。合成材料在第60天时表现出更强烈的炎症反应。除了胶原蛋白生成方面的差异外，各组之间未观察到其他差异，但在第60天时，TVT和SIS在III型胶原蛋白生成方面与筋膜组和假手术组不同。
自体筋膜产生的炎症反应和胶原蛋白较少。TVT和Marlex引起的炎症反应更强烈且持续时间更长，对内脏的穿透性更大。使用TVT时，这一过程导致III型胶原蛋白的量更高。SIS的存在虽然炎症反应比合成材料弱，但在第60天时也导致了更多的III型胶原蛋白生成。
