摘要
目的:观察兔脊髓不同平面损伤后尿流动力学变化和膀胱乙酰胆碱脂酶(AchE)、α-平滑肌肌动蛋白(α鄄SMA)表达情况,探讨神经原性膀胱类型与脊髓损伤平面的关系。方法:雄性家兔70只,分为4组,A组:T8脊髓横断,B组:T12横断,C组:L5横断,每组20只,D组:正常对照组,10只。脊髓损伤后双后肢截瘫和肛门肌电消失为全瘫标准,分别于伤后7、14、21、28d行尿流动力学、膀胱壁组织学、AchE染色与α-SMA表达观察。结果:A组逼尿肌反射亢进,括约肌不协调,残余尿多;B组逼尿肌反射亢进较轻,呈反射性排尿;C组逼尿肌无收缩反射,残余尿大量;D组正常。膀胱逼尿肌AchE染色神经纤维在A组减少,B组更少,C组最少,对照组正常。结论:T8脊髓横断组为逼尿肌反射亢进,括约肌不协调型膀胱;T12横断组为逼尿肌反射亢进至形成反射性排尿型膀胱;L5横断组为逼尿肌无力残余尿大量型膀胱。膀胱逼尿肌上AchE阳性神经纤维减少与损伤节段有关;膀胱逼尿肌α-SMA表达的上调可能是脊髓横断后膀胱顺应性降低的机制之一。
Objective:To study the urodynamics and expression of AchE,α-SMA in the bladder after spinal cord transection at different levels in rabbits.Method:Newzerland white rabbits were divided in to four groups:A,spinal cord was transected at T8level,20;B,transected at T12,20;C,transected at L5,20;D,control group,10.Complete paralysis of lower limbs and absent of anal EMG after operation were taken as the criteria.Urodynamic analysis and AchE,α-SMA expression of bladder were performed on day7,14,21,and28respectively after transection.Result:Group A,hyperreflexed detrusor with dyssynergic sphincter and increase of residual urine.GroupB,hyperreflexic detrusor and reflex urination.Group C,a contractile of detrusor with large amount residual urine.Group D,normal urodynamics.AchE stained nerve fibers in detrusor:A group decreased,B group more decreased,C group the least AchE fibers,D group normal.α-SMA expression in smooth muscles:A,B groups increased.C group decreased,D group normal.Conclusion:T8transected group:hyperreflexed detrusor with dyssynergic spincter.T12transected group:hyperreflexic detrusor reflex urination.L5transected group:acontractile detrusor with increase residual urine.The number of AchE-positive nerve fibers in detruxor urinae was related to the different segment of SCI.The high level expression ofα-SMA in bladder detrusor muscle might account for the decreased compliance of uninary bladder after SCI.
出处
《中国脊柱脊髓杂志》
CAS
CSCD
2002年第5期359-362,I005,共5页
Chinese Journal of Spine and Spinal Cord
