间歇性缺氧状态下SD幼鼠的动态尿动力学监测

Dynamic changes of urodynamic parameters before and after intermittent hypoxia exposure in rats

目的动态监测SD幼鼠间歇性缺氧前、后的尿动力学指标,探讨间歇性缺氧对SD幼鼠的膀胱尿动力学的影响。方法60d雌性SD幼鼠30只,体重(177.00±13.00)g,采用耻骨上膀胱造瘘法置入膀胱测压管,分别动态监测SD幼鼠间歇性缺氧前后的膀胱尿动力学指标,监测内容包括:①膀胱容量、排尿量、残余尿量;②启动排尿压、最大排尿压;③排尿间隔时间;④膀胱逼尿肌的不稳定收缩;⑤逼尿肌括约肌协同性。结果①间歇性缺氧前SD幼鼠的膀胱容量、排尿量分别为(0.67±0.29)ml、(0.52±0.23)ml,缺氧后其膀胱容量、排尿量明显减小;分别为(0.52±0.18)ml、(0.29±0.13)ml,两组比较差异均有统计学意义(P<0.05);缺氧前幼鼠的残余尿量为(0.15±0.04)ml,缺氧后其残余尿量明显增加,为(0.23±0.06)ml,两组比较差异有统计学意义(P<0.05);②缺氧前后SD幼鼠的启动排尿压分别为(3.74±0.97)mmHg、(3.58±0.81)mmHg,两组比较差异无统计学意义(P>0.05);缺氧前幼鼠的最大排尿压为(10.43±3;43)mmHg,缺氧后其最大排尿压明显减小,为(5.77±1.91)mmHg,两组比较差异有统计学意义(P<0.05);③缺氧前SD幼鼠的排尿间隔时间为(157.71±75.51)s,缺氧后为(84.30±38.21)s,较前明显减少,两组比较差异有统计学意义(P<0.05);④缺氧前10只幼鼠中仅有1只出现了膀胱逼尿肌不稳定收缩,明显少于缺氧后6只的数量;⑤膀胱充盈期,缺氧前10只幼鼠中有1只出现了逼尿肌括约肌协同失调,而缺氧后有2只出现;在排尿期,缺氧前10只幼鼠中有2只出现了逼尿肌括约肌协同失调,而缺氧后有3只出现。结论SD幼鼠经间歇性缺氧处理后,出现膀胱容量、排尿量、最大排尿压减少,残余尿量增多,排尿间隔时间缩短,膀胱逼尿肌不稳定收缩等膀胱尿动力学改变,而其启动排尿压未有明显改变,且缺氧前后逼尿肌括约肌协同失调表现不典型。说明间歇性缺氧对SD幼鼠膀胱储尿和排尿功能均有一定影响。

Objective To detect the dynamic changes of urodynamic parameters before and after intermittent hypoxia (IH)exposure in rats and evaluate the impact of IH on urodynamic assessment of bladder function.Methods Thirty female Sprague-Dawley (SD)rats aged 60days and weighing 177± 13grams were selected.A piezometric catheter was inserted into bladder by suprapubic cystostomy and the dynamic changes of urodynamic parameters were detected before and after IH exposure. Bladder capacity (BC),voided volume (Vv),residual volume (RV),start-up voiding pressure (SVP),maximal voiding pressure (MVP),micturition time interval (MTI),detrusor instability (DI) and detrusor-sphincter collaborative (DSC)were recorded.Results Before IH,bladder capacity and voided volume were (0.67±0.29)ml and (0.52±0.23)ml respectively.After hypoxia,both significantly declined (0.52±0.18)ml and (0.29±0.13)ml respectively and two groups showed significant statistical differences (P<0.05);residual volume at pre-hypoxia rose significantly posthypoxia [(0.15±0.04)vs (0.23±0.06)ml]and the difference was significant (P<0.05).The start-up voiding pressure at pre-and post-IH was (3.74±0.97)and (3.58±0.81)mmHg and the difference was insignificant (P<0.05);the maximal voiding pressure at pre-hypoxia decreased significantly post-hypoxia [(10.43±3.43)vs (5.77±1.91)mmHg]and the difference was significant (P<0.05);the micturition time interval pre-hypoxia decreased significantly post-hypoxia [(157.71± 75.51)vs (84.30±38.21)sec]and the difference was significant (P<0.05).Only 1/10developed detrusor instability contraction versus 6 after hypoxia.During bladder filling phase,1/10before hypoxia had detrusor-sphincter dyssynergia versus 2 after hypoxia;during voiding phase,2/10 before hypoxia had detrusor-sphincter dyssynergia versus 3 after hypoxia.Conclusions After intermittent hypoxia exposure,urodynamic changes are manifested as reductions of bladder capacity,voided volume and maximal voiding pressure,increase of residual volume,shortening of micturition time interval shortened,detrusor instability and no significant change in start-up voiding pressure before and after hypoxia.And detrusor-sphincter dyssynergia is non-typical.