神经性膀胱逼尿肌纤维化的研究

Study of Detrusor Fibrosis of Neurogenic Bladder

目的探讨神经性膀胱逼尿肌的纤维化病理生理机制。方法自21例神经性膀胱患儿和12例对照组儿童膀胱顶部切取膀胱肌层行胶原染色、苦味酸天狼星红染色、免疫组化方法观察。结果神经性膀胱逼尿肌中胶原纤维的比例、Ⅲ型胶原/Ⅰ型胶原值以及Ⅲ型胶原的高表达率(分别为31.40±2.91%,5.35±1.25,76.2%)较正常逼尿肌(分别为11.66±2.15%,2.25±0.31,25%)明显增加。结论神经性膀胱逼尿肌间质中胶原纤维明显增加,且以Ⅲ型胶原表达增加为主,是导致膀胱功能障碍的一个重要原因。

Objective To study detrusor fibrosis of neurogenic bladder.Methods 21children with neurogenic bladder and12normal children were observed.Detrusor were incised from cupular part of bladder neck during operation,then collagen in muscular layer of bladder was observed using Van Gieson(VG)staining,picri acid-sirius red staining and immunohistochemical staining respectivelys.Results Collagen,ratio of typeⅢcollagen to typeⅠcollagen and expression rate of typeⅢcollagen(31.40±2.91%,5.35±1.25,76.2%,respectively)increased in detrusor of neurogenic bladder were higher as compared with normal detrusor(11.66±2.15%,2.25±0.31,25%,respectively).Conclusions The outstanding pathological feature was collagen deposition in neurogenic bladder,and particularly in typeⅢcollagen.It may be an important reason for dysfunction of neurogenic bladder.