逼尿肌自身肌源性变化与逼尿肌不稳定的关系

Relationship between the myogenic change of detrusor and the detrusor instability

目的:探讨逼尿肌不稳定(Detrusor instability,DI)的发病机制。方法:建立Wistar大鼠膀胱流出道梗阻(Bladder outlet obstruction,BOO)动物模型,6周后行充盈性膀胱测压分出梗阻后稳定组和不稳定组,进行离体膀胱充盈性测压、逼尿肌条机械牵拉及胆碱类药物刺激试验。结果:不稳定组膀胱充盈至出现收缩时的压力明显低于稳定组及正常对照组,收缩发生时的容积明显低于稳定组;不稳定组逼尿肌条机械牵拉至其出现收缩时的最小张力明显低于稳定组及正常对照组;不同浓度氯化氨基甲酰胆碱刺激诱发的收缩频率各组间差异无统计学意义(P<0.05)。结论:逼尿肌不稳定的发生与逼尿肌自身的兴奋性增强密切相关。

Objective：To investigate the relationship between the myogenic change of detrusor and the detrusor instability. Methods：Animal models of bladder outlet obstruction（BOO） were made in female wistar rats. Six weeks later, cystometry in vitro, mechanical pull and carbocholine stimulating tests in isolated detrusor strips were done in DI group, stability group and the control. Results：In DI group , the pressure when vitro bladder contraction emergence decreased significantly as compared with the control and stability group. The volume decreased significantly as compared with the stability group（ P〈0.05）. The isolated instability detrusor contraction took place with lower tension than the control and stability group（ P〈0.05）. There is no significant difference in contraction frequence by carbocholine stimulating between all groups（ P〉0.05）. Conclusions： The increasing of detrusor excitability is closely related to DI,the neuropathogical factors seem not as important as believed.