非胰岛素依赖型糖尿病大鼠膀胱兴奋性自律性以及舒缩功能的改变

Experimental study of excitability and autorhthmicity and contraction/relaxation in urinary bladder of diabetic rats

目的 研究非胰岛素依赖型糖尿病 (NIDDM )大鼠的逼尿肌功能变化情况 ,为进一步阐明糖尿病膀胱病变的发病机理提供实验依据。方法 制造NIDDM大鼠模型 ,以正常大鼠为对照 ,分别进行残余尿测定 ,在体膀胱灌注测压观察膀胱最大容量、膀胱顺应性改变和最大逼尿肌收缩强度 (即瓦特因子 )以及采用离体逼尿肌条研究膀胱兴奋性、自律性及收缩力变化。结果 糖尿病组大鼠膀胱逼尿肌兴奋性明显低于对照组 ,自律性呈现先高后低趋势 ,最大收缩力和平均收缩力较对照组降低 ;膀胱顺应性升高 ,残余尿增多、膀胱容量增大以及膀胱湿重增加。结论 膀胱逼尿肌兴奋性降低是NVUDD的改变最早且最明显的指标。在糖尿病早期就存在逼尿肌自主节律性的变化。最初频率增加的原因可能是于逼尿肌兴奋性降低的代偿所致 ,其后表现为频率降低则是失代偿的结果。糖尿病对于膀胱收缩、舒张功能均有损害作用 ,从而导致膀胱顺应性改变。

Objective To observe the changes of bladder excitability/autorhthmicity,contraction/relaxation and compliance in experimental NIDDM rats.Methods The rats in NIDDM group and control group were subjected to urodynamic test machine after 14th and 26th weeks.At 6th/10th/14th/18th/22nd/26th weeks,the diabetes rats and controls rats had been tested by detrusor strips in vitro.Result At the early stage,the excitability of diabetes rats are depressed.The contraction and relaxation of diabetes rats are lower than the rats in controls group.The autorhthmicity of the diabetes rats higher before 22nd weeks,then lower than the controls rats.The bladder weight/residual urine and bladder compliance are increased on diabetes rats.Conclusion The excitability depressed is the first change in diabetes rats' detrusor.The autorhthmicity had also changed at the early stage.The damage of contraction and the relaxation maybe the reasons of the compliance change on the diabetes rats' bladder.