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目的:拟观察在双侧阴茎海绵体神经(CN)损伤的大鼠神经性勃起功能障碍(NED)模型中即刻和延时向阴茎海绵体注射骨髓间充质干细胞(BM-MSCs)对大鼠阴茎勃起功能的修复作用。方法:选取28只8周龄、体重200~250 g雄性SD大鼠随机分为4组:假手术组找到双侧海绵体神经后不做处理直接关腹并缝合皮肤;对照组、即刻治疗组和延时治疗组均通过钳夹的方式损伤双侧阴茎海绵体神经建立NED模型随后关腹缝合。假手术组和对照组向阴茎海绵体内注射对照剂,即刻治疗组注射BM-MSCs,延时治疗组术后两周注射BM-MSCs。术后12周采用电刺激CN记录阴茎海绵体内压(ICP),颈动脉穿刺测定平均动脉压(MAP),ICP/MAP作为勃起功能的评价指标来评估大鼠的勃起功能。在勃起功能检测后处死大鼠,取阴茎海绵体中段组织检测平滑肌、胶原和神经纤维。结果:在手术后12周,即刻治疗组和延时治疗组ICP和ICP/MAP均较对照组升高(P<0.05)。即刻治疗组和延时治疗能提高大鼠海绵体组织内平滑肌与胶原的比例(P<0.05),同时两组阴茎海绵体内平滑肌含量高于对照组(P<0.05),阴茎海绵体背神经内神经微丝(NF)蛋白阳性神经纤维数目和nNOS的表达高于对照组(P<0.05)。结论:阴茎海绵体内注射BM-MSCs能对双侧CN损伤大鼠的勃起功能恢复有促进作用。BM-MSCs治疗可以提高海绵体组织内平滑肌与胶原的比例,改善纤维化,并能提高海绵体组织中平滑肌含量、阴茎背神经的神经丝含量和nNOS的表达水平,术后延时治疗同样能取得一定的治疗效果。
OBJECTIVE: To observe the effects of immediate and delayed injection of bone marrow-derived mesenchymal stem cells (BM-MSCs) into the rat model of neurogenic erectile dysfunction (NED) with bilateral penile cavernous nerve (CN) injury on rats Penile erectile function repair effect. Methods: Totally 28 male SD rats aged 8 weeks and weighing 200 ~ 250 g were randomly divided into 4 groups: the sham-operated group was treated with bilateral cavernous nerves and then the abdomen was closed and the skin was sewn; the control group, the immediate treatment group And delayed treatment group were injured by clamping the way bilateral cavernous nerve to establish NED model and then closing the abdominal suture. The sham operation group and the control group were injected with contrast agent into the penis. The immediate treatment group was injected with BM-MSCs, and the delayed treatment group was injected with BM-MSCs two weeks after the operation. Electroencephalography (CN) was used to record penile cavernous pressure (ICP) at 12 weeks after operation. Mean arterial pressure (MAP) was measured by carotid puncture and ICP / MAP was used as an index to evaluate erectile function. Rats were sacrificed after erectile function test, and the middle part of corpus cavernosum was used to detect smooth muscle, collagen and nerve fiber. Results: At 12 weeks after operation, the ICP and ICP / MAP of the immediate treatment group and the delayed treatment group were significantly higher than those of the control group (P <0.05). Immediate treatment group and delayed treatment could increase the ratio of smooth muscle to collagen in the cavernous tissues of rats (P <0.05), while the content of smooth muscle in the penis cavernos was higher in the two groups than that in the control group (P <0.05) The number of neurofilament (NF) positive neurofilament and the expression of nNOS were higher than those in the control group (P <0.05). CONCLUSION: Injection of BM-MSCs into the corpus cavernosum can promote erectile function recovery in rats with bilateral CN injury. BM-MSCs treatment can improve the ratio of smooth muscle to collagen, improve fibrosis, increase the content of smooth muscle in corpus cavernosum, the content of nerve filaments in dorsal nerve and the expression level of nNOS in the corpus cavernosum, Obtain a certain therapeutic effect.