三种膀胱过度活动大鼠模型的尿动力学对比研究

Comparative urokinetics of three rat models of overactive bladder

目的从尿动力学层面评估膀胱出口梗阻、急性膀胱炎、完全性骶上脊髓损伤3种方法构建大鼠膀胱过度活动模型的有效性,探讨最适合用于研究儿童膀胱过度活动症(overactive bladder,OAB)发病机制模型。方法将80只雌性8周龄SD大鼠随机分成膀胱出口梗阻模型(对照组,模型2、4、6周组)、急性膀胱炎模型(对照组、模型组)、完全性骶上脊髓损伤模型(对照组,模型2、4、6周组),每小组各8只大鼠。所有小组分别进行尿动力学检查膀胱测压及膀胱容量测定。主要采用独立样本t检验对不同对照组与模型组尿动力学检测数值进行比较分析。结果①与对照组相比,膀胱出口梗阻模型组尿动力学检测提示膀胱容量升高,其中模型2周组与6周组较对照组差异有统计学意义(P<0.001,P=0.001)。②急性膀胱炎模型组最大膀胱容量下降,最大膀胱压力升高,但差异均无统计学意义(P>0.05);平均膀胱压力显著升高(P=0.006),差异有统计学意义。③完全性骶上脊髓损伤模型组最大膀胱压力和平均膀胱压力均发生下降,且随着时间越长,有明显的下降趋势,模型2周组、6周组与对照组的差异有统计学意义(P<0.001,P=0.003),模型组平均膀胱压力均下降,模型2周组、6周组与对照组的差异有统计学意义(P<0.001,P=0.006)。结论3种方式造模均能构建OAB模型,其中膀胱出口梗阻模型更适合用于儿童OAB发病机制的研究。模型2周组较4周组及6周组尿动力学表现更符合OAB表现。

Objective To construct an overactive bladder(OAB)model of bladder outlet obstruction,acute cystitis and complete supracephalus spinal cord injury in rats.Methods A total of 80 female 8-week-old Sprague-Dawley(SD)rats were randomized into bladder outlet obstruction,acute cystitis,complete superior sacral spinal cord injury(2/4/6-week)and control(n=8 each).In control group and all model groups,urodynamic examinations of bladder pressure and bladder volume were performed.Results As compared with control group,bladder volume spiked in bladder outlet obstruction model group.There was statistical difference between 2w/6w and control groups(P<0.001,P=0.001).Maximal bladder capacity declined while maximal bladder pressure rose in acute cystitis model group.There was no statistical significance(P>0.05).Average bladder pressure increased markedly(P=0.006).Maximal and average bladder pressures dropped in complete sacral spinal injury model group and there was a marked downward trend over time.The differences were statistically significant between model 2w/6w and control groups(P<0.001,P=0.003).Average bladder pressure of model group declined and there was a statistical difference between 2w/6w and control groups(P<0.001,P=0.006).Conclusions An OAB model is constructed by all three modes of modeling.As compared with acute cystitis and complete sacral nerve injury,bladder outlet obstruction model is more suitable for elucidating the pathogenesis of OAB in children.Urodynamic performance of 2w group accords more well with OAB than that of 4w/6w group.