Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, Süleyman Demirel University, Isparta, Turkey.
Arch Gynecol Obstet. 2012 Mar;285(3):757-61. doi: 10.1007/s00404-011-2072-x. Epub 2011 Sep 10.
Trimetazidine (TMZ) reduces intracellular acidosis and inhibits oxygen-derived free radicals and neutrophile infiltration in ischemia and hypoxia, which are the primary steps of adhesion formation. Our aim is to study the anti-adhesion potential of trimetazidine in a rat uterine horn model.
Forty non-pregnant female Wistar-Albino rats were randomly assigned, with ten in each group, to receive 2 ml saline, or 5 mg/kg intraperitoneal trimetazidine postoperatively, and control and sham. TMZ was administered to TMZ postoperative group 5 mg/kg i.p. daily for 5 days after the operation. Both uterine horns were exposed, and then a 2 cm segment of the anti-mesenteric surface of both the uterine horns were traumatized in 10 spots with unipolar electrocautery for 2 s with a power of 50 Watts. All the animals were killed by lethal dose of ether on postoperative 14th day. Intraperitoneal adhesions were scored by clinical adhesion scoring system, and histological and morphometric analysis was performed.
Total adhesion score (TAS) of control group was 10 while the sham group was found to be 0. TAS of the placebo group that was given saline (TAS 5), and postoperative TMZ applied group (TAS 3.5) were significantly lower than the control group (p < 0.05). The severity scores of postoperative TMZ and sham groups were significantly smaller than the other groups (p < 0.05).
TMZ significantly reduced the extent and severity of horn adhesions. The promising efficacy demonstrated by the intraperitoneal TMZ in this model warrants further investigation in clinical trials focused on gynecological procedures.
曲美他嗪（TMZ）可减少缺血和缺氧时的细胞内酸中毒，抑制氧自由基和中性粒细胞浸润，而这正是粘连形成的最初步骤。本研究旨在通过大鼠子宫角模型研究曲美他嗪的抗粘连潜力。
将 40 只未孕雌性 Wistar-Albino 大鼠随机分为 4 组，每组 10 只，分别接受术后 2ml 生理盐水、5mg/kg 曲美他嗪腹腔内注射，以及对照组和假手术组。TMZ 术后组术后每天给予 5mg/kg 曲美他嗪腹腔内注射，共 5 天。暴露双侧子宫角，然后用 50W 功率的单极电灼在每个子宫角的对系膜面的 10 个部位烧伤 2 秒，造成 2cm 段损伤。所有动物均在术后第 14 天用致死剂量的乙醚处死。采用临床粘连评分系统对腹腔内粘连进行评分，并进行组织学和形态计量学分析。
对照组的总粘连评分（TAS）为 10，而假手术组为 0。给予生理盐水的安慰剂组（TAS 5）和术后给予 TMZ 的组（TAS 3.5）的 TAS 明显低于对照组（p<0.05）。术后 TMZ 和假手术组的严重程度评分明显小于其他组（p<0.05）。
TMZ 显著降低了子宫角粘连的程度和严重程度。该模型中腹腔内 TMZ 显示出有希望的疗效，值得进一步在关注妇科手术的临床试验中进行研究。
