早期糖尿病大鼠膀胱的动力学及病理组织学

Urodynamics and Pathology in Diabetic Cystopathy Rat of the Early Stage

目的观察早期糖尿病性膀胱病(DCP)的尿动力学及病理学改变,探讨其发病机制及病理演绎过程。方法建立早期糖尿病大鼠模型(30只),以正常大鼠(30只)作对照,饲养60 d后,进行膀胱静态压、最大膀胱容量、最大膀胱收缩压等尿动力学指标测定。然后行膀胱湿重、膀胱壁厚度及光镜、电镜病理学观察。结果60 d后,糖尿病组膀胱静态压、最大膀胱容量、最大膀胱收缩压、膀胱顺应性、膀胱湿重、膀胱壁厚度分别为(0.95±0.10)kPa、(3.49±0.40)ml、(3.09±0.10)kPa、(1.39±0.11)ml/kPa、(182.0±1.5)mg、(1.41±0.07)mm,而对照组分别为(0.60±0.03)kPa、(1.82±0.12)ml、(4.91±0.30)kPa(0.68±0.07)ml/kPa、(149.0±1.4)mg、(0.93±0.04)mm。两组对应参数相比,差异均有统计学意义(P<0.05或<0.01)。糖尿病组膀胱逼尿肌边缘有空泡样变性、肌细胞固缩、细胞连接纤维化、成纤维细胞变性及胶原纤维排列紊乱。结论DCP大鼠早期就有膀胱的动力学及病理学改变,提示对DCP患者应尽早干预,控制病情的进一步恶化。

Objective To observe the abnormalities of urodynamics and histopathology in the early stage of diabetic cystopathy（DCP）. To find a relationship between the changes in the bladder function and detrusor structure and study the onset mechanism and pathology procedure in order to provide scientific bases for early stage diagnosis and treatment. Methods Thirty Wistar rat models and 30 controls were developed. In both groups, the bladder resting pressure, the bladder maximum capacity, the maximum bladder pressure and bladder compliance were measured. The bladder weights were taken, bladder wall thicknesses were measured and the histopathologic structures of bladder walls were observed by optical and electronic microscopy. Results In the diabetic rats, the the maximum bladder capacity （P〈0.01）, compliance （P〈0.05） and resting pressure （P〈 0.01） were increased, however the maximum bladder pressure decreased compared to that in the control group （P〈0.01）. The weight of diabetic rat bladder was increased compared to the control bladders（P〈0.05）. In the diabetic rats,not only the total bladder wall thickness was greater but also the muscle bundles appeared to be increased in size. In contrast to the control group, the diabetes rats showed cell obvious karyopyknosis in the detrusor,a number of compact bodies decreased and cell junction fibrosis between the detrusor cells, fibroblast degeneration and collagen fibers array disorders. Conclusion In this study,the urodynamics in the diabetic bladders show significant differences compared to the normal bladders.The detrusor microstructure show to be abnormal in the early stage of diabetes. It suggests that the bladder function is impaired obviously in the early stage of diabetes. The result of the study is concerned with fumble diabetic progress of bladder dysfunction in patient and therapeutic results.