中文摘要：

目的：通过研究3种医用组织黏合剂对胎膜组织块的毒性效应，为未足月胎膜早破（Preterm premature rupture of the membranes，PPROM）行羊膜腔封闭治疗时黏合剂的选择提供安全性依据。方法：氰基丙烯酸酯（Cyanoacrylates，CA）胶组、胶纤维蛋白胶（Fibrin sealant，vs）组、胶原蛋白（Coll组）分别作用于胎膜组织，设立空白对照（Con组）。培养24h后，胎膜小片固定、包埋、切片，进行HE染色观察组织块结构变化，TUNEL染色技术进行细胞凋亡检测；免疫蛋白印迹（Western blot）技术定量检测调节凋亡的相关蛋白Bax、Bcl-2的表达。结果：（1）HE染色显示cA组羊膜上皮层连续性被破坏，其余3组羊膜上皮层完整。（2）TUNEL染色提不cA组（51．0±1．8）％与Con组（12．1±0．8）％、FS组（16．0±0．8）％、Coll组（13．0±1．0）％相比，差异均有统计学意义（P〈0．01）；FS组与Coll组、Con组相比，差异有统计学意义（P〈0．05）；Coll组与Con组相比，差异没有统计学意义（P〉0．05）．（3）CA组、FS组、Coll组以及Con组Bax蛋白相对灰度值依次为（1．294±0．029）、（0．421±0．023）、（0．479±0．024）、（0．287±0．017），CA组、Fs组、Coll组以及Con组各组之间相比，Bax蛋白表达差异均有统计学意义（P〈0．05）。Bcl-2蛋白的相对灰度值依次为（O．350±0．034）、（0．406±0．269）、（0．433±0．020）、（0．493±0．027），CA组与Fs组、Coll组以及Con组相比，Bcl-2蛋白表达差异有统计学意义（P〈0．05）。FS组、Coll组与Con组相比，差异有统计学意义（P〈0．05）。FS组与Coll组相比，差异没有统计学意义（P〉0．05）。结论：（1）目前的CA胶尚不适用于羊膜腔封闭治疗。（2）FS和胶原蛋白对胎膜的毒性较小，从安全性方面考虑．是目前用干羊膜月牵封闭较为合活的瞑用组织黏合剂

英文摘要：

Objective：To provide safety referrences when sealing preterm premature rupture of the membranes（PPROM） by evaluating the toxicity of 3 tissue adhesives on fetal membranes. Methods：Cyanoacrylate（CA,CA group）,fibrin sealant（FS,FS group） and collagen（Coil group） were directly laid on pieces of fetal membrane and an untreated piece was chosen as control. After being incubated for 24 h,the patches were fixed,embedded and sectioned for HE staining to observe the structural changes and TUNEL staining was applied to detect the cell apoptosis. The quantity of proteins related with apoptosis（Bax and Bcl-2） was tested by Western blot. Results： （1）HE staining showed that there was consecutive rupture in the amnion layer treated with CA,while the amnion layer was complete in the other three left groups. （2）TUNEL staining showed that there were statistical differences in apoptotic rate between CA group（51.0 ± 1.8）% and Con group（ 12.1 ± 0.8）%,FS group（ 16.0±0.8）%,Coll group（ 13.0 ± 1.0）%,P〈0.01. There were statistical differences in apoptotie rate between FS group and Con group, Coll group, P〈0.05. There was no statistical difference in apoptotic rate between Coll group and Con group,P〉0.05. （3）The relative grey value of Bax protein was signifieantly increased in CA group （1.294 ± 0.029） than in FS group （0.421 ± 0.023）, Coll group （0.479 ± 0.024） and Con group （0.287 ± 0.017）（P〈0.05）. The relative grey values of Bcl-2 protein in CA group,FS group,Coil group and Con group were （0.350 ± 0.034）, （0.406 ± 0.269）, （0.433± 0.020）, （0.493 ± 0.027） respectively. CA group had lower expression of Bcl-2 than the left groups （P〈0.05）, also the expression of Bcl-2 was lower in FS group and Coll group than in Con group（P〈0.05）. No statistical difference in Bcl-2 expression was observed between FS group and Coll group（P 〉0.05 ）. Conclusions： （1）According to the research, CA is harmful to the amnion layer and