摘要
目的观察大鼠脊髓横断致神经源性膀胱不同时间点膀胱顺应性和形态学变化。方法将72只雌性Wistar大鼠随机分为假手术6周组（A组）、脊髓横断6周组（B组）、假手术12周组（C组）和脊髓横断12周组（D组）。两脊髓横断组行脊髓胸10水平完全横断，假手术组只暴露不横断脊髓。分别于术后6周和12周行尿动力学检查，膀胱标本行苏木素一伊红（HE）染色、Verhoeff-VanGieson染色，分别观察膀胱壁平滑肌、胶原纤维及弹性纤维比例的变化。结果与对照组比较，脊髓横断组大鼠出现运动和排尿功能障碍，B组膀胱顺应性较对照组升高，D组顺应性较对照组降低，差异均有统计学意义（P〈0．05），脊髓横断组肌纤维走行紊乱与胶原纤维比例增加均随损伤时间延长逐渐加重；D组与B组比较，膀胱顺应性降低[（0．046±0．023）ml／cmH2O比（0．146±0．107）ml／cmH2O（1cmH2O=0．098kPa），P〈0．01]，膀胱壁肌纤维横截面积比例降低[（46．137±4．085）％比（55．260±6．873）％，P〈0．01]而胶原纤维比例增加[（19．757±2．071）％比（11．104±1．125）％，P〈0．01]。结论大鼠脊髓横断后，随着时间的延长，膀胱顺应性呈先升高后降低的趋势，膀胱壁纤维化尤其是胶原纤维的比例增加可能是造成膀胱顺应性减低的病理基础。
Objective To observe the bladder compliance and morphological changes in rats post - suprasacral spinal cord transection at different time points. Methods Seventy - two female Wistar rats were randomly divided into four groups ： group A （ sham group of 6 weeks） ; group B （ suprasacral spi- nal cord transaction group of 6 weeks）, group C （ sham group of 12 weeks）, and group D （ suprasacral spi- nal cord transaction group of 12 weeks）. Spinal cord transection at T10 level was done in spinal cord trans- action groups, while group A and group C underwent sham operaion. Urodynamics was detected at 6th or 12th week after surgery. The changes of smooth muscle, collagen and elastic fibers ratio in the area of blad- der wall were observed by hematoxylin - eosin （HE） staining and Verhoeff - Van Gieson staining. Results The rats in spinal cord transaction groups had motor and voiding dysfunction. The bladder compliance in group B was significantly higher than in group A （ P 〈 0. 05 ）. The bladder compliance in group D was sig- nificantly lower than in group C （P 〈 0. 05）. The morphologic changes of the bladder wall in spinal cord injury groups, including the muscle fibers arranged at random and the increased collagen were aggravated with time. As compared with group B, the bladder compliance in group D was significantly decreased [ （0.046±0.023） ml/cmH20 vs. （0. 146 ±0. 107） ml/cmH20 （1 cmH2O =0.098 kPa）,P〈0. 01], the proportion of detrusor cross -sectional area was significant decreased [ （46. 137 ± 4.085）% vs. （55.260 ± 6.873）%, P〈 0.01 ], and the proportion of collagen fibers was significantly increased [ （ 19.757 ± 2. 071 ） % vs. （ 11.104 ± 1.125 ） %, P 〈 0.01 ]. Conclusion The bladder compliance in the TIO spinal cord injury rats was increased first, then decreased. The fibrosis of the bladder wall, especially the proportion of collagen fibers was increased, which might be the pathological basis of the reduced blad- der compliance.
出处
《中华实验外科杂志》
CAS
CSCD
北大核心
2016年第6期1458-1460,共3页
Chinese Journal of Experimental Surgery
关键词
脊髓横断
神经源性膀胱
膀胱顺应性
胶原纤维
Spinal cord injury
Neurogenic bladder
Bladder compliance
Collagen fiber
