膀胱出口梗阻大鼠膀胱过度活动的研究

目的:建立膀胱出口梗阻大鼠模型,诱发逼尿肌不稳定(DI),研究膀胱出口梗阻伴发膀胱过度活动的病理生理学特征。方法:选择38只成年SD雌性大鼠,随机分为模型组和对照组,结扎膀胱颈部建立膀胱出口梗阻模型。建模后3、6、9、12周采用BL-410生物机能实验系统测定膀胱压,以充盈期出现DI作为膀胱过度活动存在的标准,记录并计算DI阳性率和频率、最大排尿压(MVP)、最大膀胱容量(MCC)、膀胱顺应性(BC)和剩余尿量(PVR)。用光镜观察建模不同时期膀胱组织的病理学改变。结果:模型组大鼠3、6、9、12周DI阳性率分别为37.50%、75.00%、75.00%、62.50%。MVP、MCC、BC、PVR和DI频率较对照组增高(P<0.01),第9周大鼠PVR、MVP、MCC高于第3、6和12周。不同时期病理学改变呈现出膀胱容量增加、肌层逐渐增厚和纤维化的过程。结论:膀胱出口梗阻与逼尿肌不稳定的发生具有潜在的相关性,其病理学改变和尿流动力学参数反映了膀胱的病理生理学特点。

Overactive bladder syndrome triggered by bladder outlet obstruction

Objective:We induced bladder detrusor instability(DI) in a rat model of bladder outlet obstruction(BOO) to explore the pathophysiologic characteristics of bladder overactivity.Methods:38 adult female Sprague Dawley rats were randomly assigned to 2 groups: the BOO model group,created by ligating the bladder neck,and the control group.The cystometry was performed on Weeks 3,6,9 and 12 after surgery.The appearance of DI during the bladder storage phase served as the indicator of overactive bladder(OAB).The prevalence and the frequency of DI,maximum voiding pressure(MVP),maximum cystometric capacity(MCC),bladder compliance(BC) and post void residual(PVR) were calculated,and histopathological changes in the model group were reported for each time period.Results:The incidence of OAB in the model group was 37.5%,75.0%,75.0% and 62.5%,during Week 3,6,9,and 12,respectively.The frequency of DI,MVP,MCC,BC and PVR were significantly higher in the model group compared with controls(P<0.01).Pathological changes reported for each time period indicated thickening of the musculature of the bladder wall accompanied by fibrosis.Conclusions:There is a underlying relationship between bladder outlet obstruction and detrusor instability,the pathological changes and urodynamic parameters could reflect the characteristics of bladder pathophysiology.