膀胱出口部分梗阻大鼠膀胱超微结构和尿流动力学的关系

The relationship between the ultrastructure and urodynamic in partial bladder outlet obstruction rats

目的观察大鼠膀胱出口部分梗阻(PBOO)后尿流动力学及超微结构变化,探讨膀胱出口部分梗阻后超微结构和尿流动力学改变的关系。方法 48只雌性Sprague-Dawley大鼠随机分为假手术组(Sham组)24只、PBOO 2周组8只、4周组8只、8周组8只。饲养后,于相应周数解剖膀胱,测定膀胱重量、不稳定收缩发生率、容量、漏尿点压及膀胱顺应性,观察逼尿肌超微结构改变等指标。结果 PBOO 2周、4周、8周膀胱重量分别为(220±24.2)mg、(327.8±27.7)mg、(521.6±24.7)mg,Sham组为(108.5±6.3)mg(P<0.05);不稳定收缩发生率分别为50%(4/8)、87.5%(7/8)、37.5%(3/8),Sham组0%为(0/24)(P<0.05);膀胱最大容积分别为(0.65±0.26)mL、(1.57±0.70)mL、(5.62±1.39)mL,Sham组为(0.30±0.08)mL(P<0.05)。梗阻组漏尿点压为2周组(31.5±4.78)cmH2O、4周组(56.5±7.46)cmH2O、8周组(33.00±9.92)cmH2O,Sham组(22.13±3.18)cmH2O(P<0.05)。膀胱顺应性PBOO 2周组、4周组与Sham组比较,差异无统计学意义(P>0.05),8周组与Sham组相比,差异有统计学意义(P<0.05)。透射电镜观察结果为大鼠PBOO后线粒体增多、水肿,细胞膜穴样凹陷增多,中间连接减少、缝隙连接及胞突连接增多。结论膀胱出口部分梗阻后由代偿期进入失代偿期,可以通过尿流动力学进行检测,而产生这一系列变化的形态学基础可能是超微结构的改变。

Objective To investigate the relationship between ultrastructure and urodynamic after partial bladder outlet obstruction（PBOO） in rats. Methods A total of 48 female Sprague-Dawley rats were randomly divided into sham operation group （n=24）, partial outlet obstruction for 2 weeks group （PBOO 2 W, n=8）, partial outlet obstruction for 4 weeks group （PBOO 4 W, n=8）, and partial outlet obstruction for 8 weeks group （PBOO 8 W, n=8）. After the animals were sacrificed, the bladder weight, rate of bladder instability, capacity, leak point pressure, compliance and ultrastucture were observed. Results Bladder weight of PBOO 2 W, 4 W, 8 W group was （220±24.2）mg, （327.8±27.7）mg, （521.6±24.7）mg, respec- tively, which was higher than that of the sham group （108.5 ± 6.3）mg, （P〈0.05）. The rate of bladder instability of PBOO 2 W,4 W, 8 W group was 50%0（4/8）, 87.5%（7/8）, and 37.5%（3/8）, which was higher than that of the sham group 0% （0/ 24） （P〈0.05）. The maximum volume was （0.65±0.26）mL, （1.57±0.70）mL, and （5.62±1.39）mL, higher than that of the sham group （0.30±0.08）mL, （P〈0.05）. The link point pressure was （31.5±4.78） cmH20, （56.5 ± 7.46） cmH2O, and （33.00± 9.92） cmH2 O, higher than that of the sham group （22.13± 3.18） cmHz O, （P〈0.05）. The bladder compliance of PBOO 2 W, 4 W and 8 W group was higher than that of the sham group, but PBOO 2 W and 4 W group had no statistic sig- nificance compared with the sham group （P〉0.05）. TEM observation showed increased mitochondria, edema, membrane caveolae, gap junction, and synapses connection, but reduced intermediate connection. Conclusion After bladder outlet par- tial obstruction, compensated and decompensated process can be detected by urodynamic, and the basis of morphological chan- ges may be caused by ultrastructure alterations.