大鼠脊神经离断神经源性膀胱模型的建立

The establishment of a neurogenic bladder model through spinal nerve transection in rats

目的建立大鼠脊神经离断神经源性膀胱（NB）模型并对其进行影像尿动力学评估。方法25只8周龄健康雌性SD大鼠，体重200～220 g，按照随机数字表法分为NB组（n＝15）和假手术（Sham）组（n＝10）。NB组大鼠行椎管内双侧腰6（L6）和骶1（S1）脊神经离断，Sham组只行椎板切除，不离断脊神经。术后1个月，两组大鼠行影像尿动力学评估。结果NB组大鼠术后出现排尿障碍，表现为下腹部饱满，可触及因尿潴留而增大的膀胱，按摩下腹部有较多尿液排出，Sham组大鼠无上述排尿障碍表现。影像尿动力学检查结果示：与Sham组比较，NB组大鼠逼尿肌无明显收缩，最大膀胱测压容量[（3.97±0.90） ml比（1.03±0.21） ml]和膀胱顺应性[（0.203±0.068） ml/cmH2O比（0.037±0.010） ml/cmH2O（1 cmH2O＝0.098 kPa）]明显增加（t＝10.070，P＝0.000；t＝7.616，P＝0.000），逼尿肌漏尿点压[（20.64±5.03） cmH2O比（27.88±3.94） cmH2O]明显降低（t＝3.746，P＝0.001）；同步影像检查结果显示与Sham组大鼠比较，NB组大鼠膀胱容积增大，呈＂橄榄球＂状。结论采用脊神经离断法能建立大鼠逼尿肌无收缩NB模型。

ObjectiveTo establish a neurogenic bladder （NB） model through spinal nerve transection in rats and to evaluate the model with video-urodynamic.MethodsTwenty five female Sprague-Dawley （SD） rats [mean weight （200-220） g, 8 weeks old] were randomly divided into NB group （n=15） and Sham group （n=10）. In NB group rats, the bilateral lumbar 6（L6）and sacral 1（S1）spinal nerves were transected in dura. In Sham group rats, only laminectomy was performed. Video-urodynamic assessment was carried out one month postoperatively.ResultsThe voiding dysfunction was observed in NB group rats, which showed full lower abdomen and discharged more urine by squeezing the increased bladder. The Sham group showed no significant abnormality. The video-urodynamic showed detrusor areflexia of rats in the NB group. The maximum bladder capacity （MBC） and bladder compliance （BC） increased significantly in NB group than those of Sham group [MBC： （3.97±0.90） ml vs. （1.03±0.21） ml; BC： （0.203±0.068） ml/cmH2O vs. （0.037±0.01） ml/cmH2O）] （t=10.070, P=0.000; t=7.616, P=0.000）. However, the detrusor leak point pressures （DLPP） decreased significantly in NB group than those of Sham group [DLPP： （20.64±5.03） cmH2O vs. （27.88±3.94） cmH2O] （t=3.746, P=0.001）. Simultaneous images showed that the bladder volume of the rats in the NB group was increased as rugby compared with Sham group.ConclusionThis procedure of spinal nerve transaction can be used to establish NB rat model with acontractile detrusor.