两种去神经支配压力性尿失禁模型的比较

Comparison of two denervated rat models of stress urinary incontinence

目的比较两种去神经支配压力性尿失禁（SUI）模型的效果。方法30只雌性Wistar大鼠随机分为3组。测漏尿点压力（LPP），3组分别切断坐骨神经、阴部神经和只游离不切断，术后2周测LPP，行喷嚏试验。术后1月行尿道组织学检查。解剖坐骨、阴部神经。结果3组术前LPP差异无统计学意义（P〉0．05）。对照组手术前后LPP分别为（27．56770±5．43489）、（30．13220±5．79094）cmH2O，差异无统计学意义（P〉0．05）；坐骨神经组为（30．91100±5．46762）、（30．40080±5．51554）cmH2O，差异无统计学意义（P〉0．05）；阴部神经组为（27．84930±5．23036）、（9．58830±2．34255）cmH2O，差异有统计学意义（P〈0．01）。阴部神经组术后喷嚏时漏尿，镜检尿道括约肌萎缩。解剖证明坐骨、阴部神经各自独立，支配尿道括约肌的是阴部神经。结论切断阴部神经可以建立大鼠去神经支配SUI模型，切断坐骨神经则不能。

Objective To compare the efficacy of two denervated rat models of stress urinary incontinence （SUI）. Methods A total of 30 healthy female Wistar rats were randomly allocated into three groups. The leak point pressure （LPP） was measured. Then bilateral sciatic, pudendal nerves were respectively transected in sciatic nerve group and pudendal nerve group. These nerves were isolated only in the control group. Two weeks later, the LPP was measured again, and sneeze test was performed. Histological analysis was performed at the first month postoperatively. The two nerves were dissected. Results In control group, the preoperative and postoperative LPP was （27. 567 70 ± 5. 434 89）, and （30. 132 20 ± 5. 790 94） cm H2O,respectively （ P 〉 0.05 ）. In sciatic group, the LPP was （ 30.911 00 ± 5. 467 62 ）, and （ 30. 400 80 ± 5. 515 54） cm H2O,respectively （P 〉0.05）. In pudenda group,the LPP was （27. 849 30 ±5. 230 36）, and （9.588 30 ± 2.342 55 ） cm H2O, respectively （ P 〈 0.01 ）. In the pudendal nerve denervated rats, SUI occurred in 100% rats. H＆E staining of the urethral sphincter was atrophic. The pudendal nerve was the dominant nerve of rat urethral sphincter. Conclusion It＇ s feasible to establish the denervated rat model of SUI by bilateral pudendal nerve transaction. On the contrary, bilateral sciatic nerve transaction is null and void.