钬激光烧灼大鼠膀胱黏膜后的形态和细胞凋亡指数的改变及意义

The alteration and significance of morphology and apoptosis index of bladder epithelium treated with Holmium∶YAG laser in rats

目的:评价钬激光对膀胱黏膜破坏作用,探讨钬激光误伤膀胱黏膜后治疗办法。方法:根据是否接受钬激光烧灼和术后静注地塞米松,将实验鼠分为三组:对照组、钬+生组和钬+地组。通过建立钬激光灼伤大鼠膀胱黏膜模型,观察被钬激光灼伤后其髓过氧化氢酶(MPO)、过氧化氢酶(CAT)、超氧化物歧化酶(SOD)活性、丙二醛(MDA)的含量以及血管生长、移行上皮组织形态、上皮细胞凋亡指数的改变。结果:光镜下对照组的膀胱壁各层少许炎性细胞浸润;钬+生组膀胱壁黏膜层和肌层内小血管充血明显,大量炎性细胞浸润。部分黏膜层已脱落,脱落处炎症表现较重;钬+地组膀胱各层小血管充血明显,较多炎性细胞浸润;钬+生组膀胱壁各层大量移行上皮细胞凋亡,对照组、钬+地组膀胱各层部分移行上皮细胞凋亡,但凋亡程度均较钬+生组轻;钬+地组BvC(P<0.01)、BvSAP(P<0.05)、BvSAD(P<0.05)及AI(P<0.01)与对照组、钬+生组相应值对比差异有统计学意义;钬+生组MPO活力、CAT活力和MDA含量与钬+地组相比差异有统计学意义(P<0.01);SOD活力与钬+地组相比差异有统计学意义(P<0.05)。结论:钬激光烧灼对膀胱黏膜上皮细胞有破坏作用。糖皮质激素可以减轻这种破坏作用。

Objective：To investigate the alteration and significance of morphology and apoptosis index of bladder epithelium treated with Holmium：YAG laser in rats. Methods：The bladders of 48 adult male Sprague-Dawley rats were treated with Holmium：YAG laser. The rats＇ bladders were collected for detecting the configuration and apoptosis of rat＇s bladder transitional epithelium. Results： Every slide was carefully viewed with a microscope. There are no much leukocyte in the bladders epithelium of group ControL-Group, much leukocyte and blood stasis phenomena, even pus, in those of group HYL＋S, much blood stasis phenomena in those of group HYL＋G; There are lots of apoptotic transitional epithelium cells in the bladders of group HYL＋S, much more than group ControL-Group,HYL＋G; The change of BvC, BvSAP, BvSAD, AI, MPO, CAT, and MDA were noted in bladder transitional epithelium of group HYL＋S compared with group ControL-Group, HYL＋G. Conclusions： Although the Holmium： YAG laser with its ability to cut tissue precisely and provide hemostasis combined with its versatility and compatibility with flexible endoscopes is an ideal instrument for safely performing endoureterotomy, damage always occurs when the laser impacted bladder epithelium. The use of glucocorticoid may be beneficial in decreasing this damage following the Holmium： YAG laser＇s treatment.