逼尿肌中神经元密度改变与逼尿肌活动低下的关系-第三军医大学学报.DOCVIP

膀胱出口梗阻对逼尿肌收缩及其神经支配的影响 封建立，孙道冬，蒙明森，颜加强，刘元丰，康元上，舒勇，高瑾，孙丹宁 重庆市中国人民解放军324医院泌尿外科，400020 【摘要】目的：观察膀胱出口梗阻后逼尿肌神经纤维密度及逼尿肌收缩力的改变，初步探讨膀胱出口梗阻对逼尿肌收缩力的影响及其机制。方法：近端尿道结扎法建立大鼠膀胱出口部分梗阻模型，实验动物分四组：假手术6周组、假手术8周组、梗阻6周组以及梗阻8周组。采用免疫荧光组织化学技术检测神经纤维的表达；利用体外肌条实验测定肌条收缩力。结果：梗阻组逼尿肌中神经纤维密度均较对应假手术组显著降低，差异非常显著（P0.01)，梗阻8周组较梗阻6周组逼尿肌中神经纤维密度显著降低，差异显著（P0.05)；梗阻6周组逼尿肌条收缩幅度较假手术组明显升高，差异非常显著（P0.01)，梗阻8周组逼尿肌条收缩幅度较假手术组明显降低，差异非常显著（P0.01)。结论：膀胱出口部分梗阻可以导致逼尿肌中神经纤维密度单向减少；而逼尿肌收缩幅度呈双向性改变，即先升高后降低，提示逼尿肌收缩力改变与其内部神经支配无明显关系，可能源于自身肌源性因素。 【关键词】膀胱出口梗阻；过度活动膀胱；逼尿肌活动低下；神经支配 中图法分类号：R361.2；R334.3; R363.14 The effects of bladder outlet obstruction on the contractility and the innervation of detrusor muscle. Feng Jianli, Sun Daodong, Meng Mingsen, Yan Jiaqiang, Liu Yuanfeng, Kang Yuanshang, Gao Jin,Sun Danning. The Department of Urology,324 hospital of PLA, Chong Qing,400020 Abstract Objective: To study the change of contractility and innervation of detrusor muscle after bladder outlet obstruction(BOO), and then to investigate the effects of BOO on detrusor contractility and the mechanism under it. Methods: Rat BOO model was established by partial ligation of proximal urethra. All the experimental animal were divided into four groups: sham-operated 6 weeks group(SO6), obstruction 6 weeks group (OB6), sham-operated 8 weeks group(SO8)and obstruction 8 weeks group(OB8).The expression of nerve fibres(NF) were detected by immunofluorescence histochemistry. The contractility of detrusor muscle was tested by in vitro strips experiment. Results:The density of NF in OB6 and OB8 groups decreased obviously than that in SO6 and SO8 groups. And the density of NF in OB8 group was significantly smaller than that in OB6 group. The contractile amplitude of OB6 group was much higher than that of SO6 group, while the contractile amplitude of OB8 group was significantly lower than that of SO8. [基金项目]?cstc2012jjA1566） 作者简介：封建立，男，汉族，博士，主治医师。主要研究方向：膀胱功能障碍。联系方式：023E-mail：f-jianli@163.com. lower than that of SO8 group. Conclusion:BOO might caus