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目的:建立膀胱出口梗阻大鼠模型,诱发逼尿肌不稳定(DI),研究膀胱出口梗阻伴发膀胱过度活动的病理生理学特征。方法:选择38只成年SD雌性大鼠,随机分为模型组和对照组,结扎膀胱颈部建立膀胱出口梗阻模型。建模后3、6、9、12周采用BL-410生物机能实验系统测定膀胱压,以充盈期出现DI作为膀胱过度活动存在的标准,记录并计算DI阳性率和频率、最大排尿压(MVP)、最大膀胱容量(MCC)、膀胱顺应性(BC)和剩余尿量(PVR)。用光镜观察建模不同时期膀胱组织的病理学改变。结果:模型组大鼠3、6、9、12周DI阳性率分别为37.50%、75.00%、75.00%、62.50%。MVP、MCC、BC、PVR和DI频率较对照组增高(P<0.01),第9周大鼠PVR、MVP、MCC高于第3、6和12周。不同时期病理学改变呈现出膀胱容量增加、肌层逐渐增厚和纤维化的过程。结论:膀胱出口梗阻与逼尿肌不稳定的发生具有潜在的相关性,其病理学改变和尿流动力学参数反映了膀胱的病理生理学特点。
OBJECTIVE: To establish a rat model of bladder outlet obstruction, induce detrusor instability (DI) and study the pathophysiological characteristics of bladder outlet obstruction with overactive bladder. Methods: Thirty-eight adult female Sprague-Dawley rats were randomly divided into model group and control group. The model of bladder outlet obstruction was established by ligating the bladder neck. Blast pressure was measured at 3, 6, 9 and 12 weeks after BL model was established by BL-410 bio-functional test system, and DI was present during filling as the standard of overactive bladder. DI positive rate and frequency, maximum voiding pressure ), Maximum bladder capacity (MCC), bladder compliance (BC) and residual urine output (PVR). The pathological changes of bladder tissue in different periods of modeling were observed with light microscope. Results: The positive rates of DI at 3, 6, 9 and 12 weeks in model group were 37.50%, 75.00%, 75.00% and 62.50%, respectively. The frequencies of MVP, MCC, BC, PVR and DI were higher than those of the control group (P <0.01). The PVR, MVP and MCC of the 9th week were higher than those of the 3rd, 6th and 12th week. Pathological changes in different periods showed increased bladder capacity, myometrial gradually thickening and fibrosis process. Conclusions: Bladder outlet obstruction has a potential correlation with detrusor instability. The pathological changes and urodynamic parameters reflect the pathophysiological features of the bladder.