宫颈炎引起膀胱过度活动症的神经机制研究

Study on the nerval mechanism of overactive bladder following cervicitis

目的探讨慢性宫颈炎引起排尿异常的神经机制。方法电刺激大鼠子宫颈,记录膀胱的肌电活动及其在神经封闭、植物神经切除后的变化。结果电刺激大鼠子宫颈时在膀胱肌层可记录到较稳定的、波形呈慢波的肌电活动波。利多卡因阻滞子宫颈组织内的神经传导后,可使膀胱肌电活动波幅下降,潜伏期延长,与阻滞前相比,差异均有统计学意义(P<0.01);而改用生理盐水子宫颈注入前后各时段波幅和潜伏期差异均无统计学意义(P>0.05);颈髓横断后对膀胱肌电活动无显著影响。破坏同侧T13～L5交感神经干后对膀胱肌电活动有显著影响;而同侧L6～S3副交感神经切断后,膀胱肌电活动波基本消失。结论子宫颈与膀胱间存在神经反射,可能为脊髓固有的神经反射,通过此反射宫颈炎时可以引起膀胱过度活动症。

Objective To investigate the neurological mechanism of the micturition symptom induced by the cervicitis.Methods The bladder myoelectrical activities were recorded when the cervix was electrically stimulated.The changes of blocking or destroying the autonomic nerves were observed.Results The stable myoelectrical wave displayed in the bladder wall when the cervix was stimulated by the electricity in rats,and the wave was a typically slow wave.The latent period of myoelectrical wave of urinary bladder was gradually extended and amplitude of the wave was reduecd after blocking the nerves in the cervix with the lidocaine.The myoelectrical wave of urinary bladder disappeared after executing the rats by the excess anesthetic.The myoelectrical activities of urinary bladder were not alternated after the cervical cord was transected（P0.05）,but significantly influenced after destroying the sympathetic nerves stem inT13-L5（P0.01）.The wave almost disappeared after cutting the parasympathetic nerves in L6-S3.Conclusion The stimulus to the cervix in cervicitis may cause the changes of the bladder functions in rats by the neural reflex.The reflex might be an intrinsic viscero-viscer one in spinal cord,and it may be the cause of some micturition symptoms in overactive bladder.