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输尿管膀胱连接部梗阻导致兔远端输尿管平滑肌收缩力和胆碱能及肾上腺素能活性增加。

Ureterovesical junction obstruction causes increment in smooth muscle contractility, and cholinergic and adrenergic activity in distal ureter of rabbits.

机构信息

Department of Pediatric Surgery, Hacettepe University, Faculty of Medicine, Sihhiye, Ankara, 06100 Turkey.

出版信息

J Pediatr Surg. 2013 Sep;48(9):1954-61. doi: 10.1016/j.jpedsurg.2013.01.030.

Abstract

BACKGROUND/PURPOSE: The controversy in management of primary obstructed megaureter necessitates further elucidation of the underlying pathophysiology. We evaluated smooth muscle contractility, and cholinergic, adrenergic and serotonergic activity of rabbit distal ureters after ureterovesical junction (UVJ) obstruction.

METHODS

Sham (SH) operation, partial obstruction (PO) and complete obstruction (CO) of the right UVJ were performed in rabbits. Three weeks later, distal ureters were isolated; spontaneous contractions (SC), contractile responses to electrical field stimulation (EFS), high KCl, carbachol, phenylephrine and serotonin were recorded.

RESULTS

SC amplitudes increased in CO compared to PO and SH (p<0.001). SC frequency was higher in CO (p<0.05). EFS-induced contraction amplitudes were greater in CO than other groups (p<0.05). High KCl-induced contractions were greater in CO (p<0.001) and PO (p<0.01). Carbachol-induced contractility was enhanced in CO and PO (p<0.05). Contractile response to phenylephrine was greater in CO than other groups (p<0.05). Serotonin induced contractile responses in CO and PO, greater in CO (p<0.05). UVJ obstruction also increased spontaneous contractility in contralateral PO and CO ureters.

CONCLUSIONS

UVJ obstruction increased spontaneous and neurotransmitter-induced contractions in an obstruction grade-dependent manner. Obstruction also altered contractility of the contralateral ureters. Our findings may serve to provide further understanding of the pathophysiology of megaureter.

摘要

背景/目的:原发性巨输尿管梗阻的处理存在争议,需要进一步阐明其潜在的病理生理学机制。我们评估了兔肾盂输尿管连接部(UVJ)梗阻后远端输尿管的平滑肌收缩性,以及胆碱能、肾上腺素能和 5-羟色胺能活性。

方法

对兔行假手术(SH)、部分梗阻(PO)和完全梗阻(CO)。3 周后,分离远端输尿管;记录自发性收缩(SC)、电刺激(EFS)、高钾、卡巴胆碱、苯肾上腺素和 5-羟色胺诱导的收缩反应。

结果

与 PO 和 SH 相比,CO 组的 SC 幅度增加(p<0.001)。CO 组的 SC 频率更高(p<0.05)。EFS 诱导的收缩幅度在 CO 组大于其他组(p<0.05)。高钾诱导的收缩在 CO 组(p<0.001)和 PO 组(p<0.01)更大。CO 和 PO 组的卡巴胆碱诱导的收缩性增强(p<0.05)。CO 组对苯肾上腺素的收缩反应大于其他组(p<0.05)。CO 和 PO 组中 5-羟色胺诱导的收缩反应更大(p<0.05)。UVJ 梗阻还增加了对侧 PO 和 CO 输尿管的自发性收缩。

结论

UVJ 梗阻以梗阻程度依赖的方式增加自发性和神经递质诱导的收缩。梗阻还改变了对侧输尿管的收缩性。我们的发现可能有助于进一步了解巨输尿管的病理生理学。

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