脊髓损伤性神经原性膀胱逼尿肌受体改变研究

目的研究脊髓损伤性神经原性膀胱逼尿肌M3、α1及β3受体密度改变及尿流动力学改变。方法手术方法建立脊髓损伤性骶上及骶下型神经原性膀胱动物模型,尿动力检测及行为学证实成功,采用放射配基方法测定相应逼尿肌标本M3、α1及β3受体密度。结果尿流动力学检测结果与正常对照相比,骶上型表现为高压痉挛型即膀胱容量下降、逼尿肌压力增高、顺应性下降,逼尿肌受体密度表现为M3受体密度增高,较骶下型增高更为明显,α1受体密度增高,β3受体密度较对照犬降低;骶下型犬表现为弛缓性膀胱,即膀胱容量增大,逼尿肌压力有降低,膀胱顺应性增高,逼尿肌受体密度测定显示其M3受体密度较正常对照增高,但增高幅度较骶上型低,α1受体密度则较正常降低,β3受体密度较对照犬增高。结论神经原性膀胱逼尿肌不稳定的发生与M3、α1及β3受体密度改变密切相关。

Study of the urodynamic and receptor changes in neurogenic bladder by spinal cord injury

Objective To study the urodynamic and M3,α1,β3 receptor changes in neurogenic bladder by spinal injury.Methods the suprasacral and subsacral models were established by surgical spinal injury and confirmed by urodynamic and ethologic exam M3,α1,β3 receptor changes in the detrusor muscle were detected by radio ligand binding assay.ResultsWhen compared with normal control,the urodynamic exam of suprasacral models showed decreased bladder volume,accentuation of detrusor muscle reflex and low compliance bladder with increased M3,α1 receptor,decreasedβ3 receptor in detrusor muscle.In subsacral models,detrusor muscle reflex was decreased and bladder volume were increased which showed a high compliance bladder.M3 andβ3 receptor,were increased whileα1 receptor was decreased in detrusor muscle.Conclusion The instability in neurogenic bladder has close correlation with the changes of M3,α1,β3 receptor in detrusor muscle.