【摘要】：陰道萎縮是一種常見的主訴，尤其是在絕經(jīng)后的婦女。陰道萎縮嚴重影響婦女的生活質量，，目前治療陰道萎縮主要通過激素治療為主，但是激素治療會帶來諸多不良反應。 目的：探討透明質酸陰道凝膠（海羅芬）在去勢大鼠中的作用。 方法：實驗選用雌性SD大鼠60只，隨機分為3組，分別為去勢+海羅芬組（OVX+Hyalofemme），單獨去勢組（OVX）以及假手術組（Sham-OVX）。去勢+海羅芬組以及單獨去勢組共40只大鼠行卵巢切除術，假手術組20只大鼠切除等量脂肪組織。術后3天開始陰道脫落細胞檢測，直到陰道上皮細胞沒有動情周期改變。去勢+海羅芬組給予海羅芬陰道給藥，單獨去勢組以及假手術組給予空白凝膠陰道給藥。兩周后取陰道分泌物行陰道微環(huán)境檢測，后處死大鼠，取出子宮及陰道，稱取子宮重量，陰道上皮行HE染色、透射電鏡、P-AKt、VEGF的檢測。 結果：1、去勢+海羅芬組和單獨去勢組子宮重量低于假手術組，差異有統(tǒng)計學意義（p＜0.05）；去勢+海羅芬組與單獨去勢組子宮重量相比，無顯著性差異。2、光鏡下見去勢+海羅芬組大鼠陰道上皮厚于單獨去勢組，差異有統(tǒng)計學意義（p㩳0.05）；單獨去勢組中大鼠陰道上皮薄于假去勢組，差異有統(tǒng)計學意義（p㩳0.05）；假去勢組中大鼠陰道上皮厚于去勢+海羅芬組，差異有統(tǒng)計學意義（p㩳0.05）。3、電鏡下可見去勢+海羅芬組中陰道上皮細胞排列緊密，細胞橋粒及張力微絲豐富，內質網(wǎng)及核糖體量多；單獨去勢組中陰道上皮細胞排列疏松，細胞間隙較寬，核染色質邊集，可見核固縮，核碎裂及核溶解；假手術組中陰道上皮細胞表現(xiàn)與去勢+海羅芬組相似。4、大鼠陰道分泌物檢測顯示，去勢+海羅芬組白細胞酯酶、β-葡萄糖醛酸酶和凝固酶表達水平較假單獨去勢組相似，在統(tǒng)計學差異；單獨去勢組中白細胞酯酶、β-葡萄糖醛酸酶和凝固酶表達水平與假去勢組和去勢+海羅芬組相比較高，差異有統(tǒng)計學意義（p＜0.01）；假去勢組中白細胞酯酶、β-葡萄糖醛酸酶和凝固酶表達水平較低。5、Western blot檢測各組陰道組織P-AKt和VEGF的表達：去勢+海羅芬組與假去勢組相比P-AKt和VEGF的表達相似；與去勢+海羅芬組和假手術組相比，單獨去勢組P-AKt和VEGF的表達明顯降低。 結論：透明質酸陰道凝膠可以有效的緩解陰道萎縮。透明質酸陰道凝膠可以改善陰道局部微環(huán)境，同時也可以改善陰道上皮的修復能力。
[Abstract]:Vaginal atrophy is a common complaint, especially in postmenopausal women. Vaginal atrophy seriously affects the quality of life of women. At present, vaginal atrophy is mainly treated by hormone therapy, but hormone therapy will bring many adverse reactions. Objective: to investigate the role of hyaluronic acid vaginal gel (Herofine) in ovariectomized rats. Methods: sixty female Sprague-Dawley rats were randomly divided into three groups: castration group, (OVX Hyalofemme), group, (OVX) group and sham operation group (Sham-OVX). Ovariectomy was performed in 40 rats in ovariectomized group and ovariectomized group in 20 rats in sham-operated group. Vaginal exfoliative cells were detected 3 days after operation until vaginal epithelial cells did not change estrous cycle. The ovariectomized group was given hydrophen vaginal administration, the single castrated group and the sham operation group were given blank gel vaginal administration. Two weeks later, vaginal secretions were taken for vaginal microenvironment detection, then rats were killed, uterus and vagina were taken out, uterine weight was taken out, vaginal epithelium was stained with HE, and VEGF was detected by transmission electron microscope (TEM). Results the weight of uterus in castration group and single castration group was significantly lower than that in sham operation group (p < 0.05), and the uterine weight in castration group was higher than that in castrated group (p < 0.05), and the uterine weight in castration group was significantly lower than that in ovariectomized group (p < 0.05). There was no significant difference in the thickness of vaginal epithelium between castrated group and ovariectomized group under light microscope (p0.05), but the thickness of vaginal epithelium in castration group was thinner than that in sham castration group (p0.05). The vaginal epithelium in ovariectomized group was thicker than that in ovariectomized group, the difference was statistically significant (p0.05) .3The results of electron microscope showed that the vaginal epithelial cells in ovariectomized group were closely arranged, the desmosomes and tension microfilaments were abundant, and the amount of endoplasmic reticulum and ribosome was more. In the castrated group, the vaginal epithelial cells were arranged loosely, the intercellular space was wide, the chromatin edge was gathered, the nuclei were pyknosis, nuclear fragmentation and nuclear dissolution. The expression of leucocyte esterase, 尾 -glucuronidase and coagulase in ovariectomized group was similar to that in ovariectomized group, and the expression of leucocyte esterase, 尾 -glucuronidase and coagulase in castrated group was similar to that in ovariectomized group. The expression levels of leucocyte esterase, 尾 -glucuronidase and coagulase in castration group were significantly higher than those in sham castration group and ovariectomized group (p < 0.01). The expression levels of leucocyte esterase, 尾 -glucuronidase and coagulase were lower in ovariectomized group. 5Western blot was used to detect the expression of P-AKt and VEGF in vaginal tissue of each group. The expression of P-AKt and VEGF in castrated group was similar to that in pseudocastrated group. The expression of P-AKt and VEGF in ovariectomized group was significantly lower than that in ovariectomized group and sham-operated group. Conclusion: hyaluronic acid vaginal gel can effectively relieve vaginal atrophy. Hyaluronic acid vaginal gel can improve local microenvironment and repair ability of vaginal epithelium.
【學位授予單位】：重慶醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R711.74

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