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一种新型脑出血诱导的神经源性排尿功能障碍大鼠模型:下尿路功能分析。

A novel intracerebral hemorrhage-induced rat model of neurogenic voiding dysfunction: Analysis of lower urinary tract function.

作者信息

Cho Young-Sam, Ko Il-Gyu, Kim Chang-Ju, Kim Khae-Hawn

机构信息

Department of Urology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 110‑746, Republic of Korea.

Department of Physiology, Kyung Hee University College of Medicine, Seoul 130‑701, Republic of Korea.

出版信息

Mol Med Rep. 2015 Aug;12(2):2563-9. doi: 10.3892/mmr.2015.3720. Epub 2015 May 4.

Abstract

Neurogenic lower urinary tract dysfunction (NLUTD) is a major problem in patients with various neurological disorders, and may result in debilitating symptoms and serious complications, including chronic renal failure and recurrent urinary tract infections. Clinically, stroke is associated with voiding dysfunction. However, lower urinary tract function evaluation in an intracerebral hemorrhage (ICH) model has not, to the best of our knowledge, been reported. Therefore, in the present study, lower urinary tract function in ICH-induced rats was investigated and the results were compared with those obtained in normal rats. The effects of ICH on peripheral bladder function and central micturition centers [medial preoptic area, ventrolateral gray, pontaine micturition center and spinal cord (lumbar 4 (L4)-L5)] were also examined. Adult female Sprague-Dawley rats were divided into two groups: Control ICH-induced. Induction of ICH in the hippocampal CA1 region was performed using a stereotaxic frame and type IV collagenase. The effects of ICH on the central micturition centers were investigated by simultaneously determining the extent of neuronal activation (c-Fos) and nerve growth factor (NGF) expression, and assessing voiding function (urodynamically using cystometry). The results revealed that induction of ICH significantly enhanced bladder contraction pressure and time, while simultaneously reducing voiding pressure and time. Furthermore, the c-Fos and NGF expression levels in the neuronal voiding centers were significantly increased in the rats with induced ICH as compared with the control rats. Therefore, this ICH-induced NLUTD rat model may be a more appropriate method to analyze NLUTD in stroke patients than a cerebral infarction model, as the former more accurately reflects the nature of the hemorrhage in the two types of stroke.

摘要

神经源性下尿路功能障碍(NLUTD)是各种神经系统疾病患者面临的一个主要问题,可能导致使人衰弱的症状和严重并发症,包括慢性肾衰竭和反复的尿路感染。临床上,中风与排尿功能障碍有关。然而,据我们所知,尚未有关于脑出血(ICH)模型中下尿路功能评估的报道。因此,在本研究中,我们对ICH诱导的大鼠的下尿路功能进行了研究,并将结果与正常大鼠的结果进行了比较。我们还研究了ICH对膀胱外周功能和中枢排尿中枢[视前内侧区、腹外侧灰质、脑桥排尿中枢和脊髓(腰4(L4)-L5)]的影响。成年雌性Sprague-Dawley大鼠被分为两组:对照组和ICH诱导组。使用立体定位框架和IV型胶原酶在海马CA1区诱导ICH。通过同时测定神经元激活程度(c-Fos)和神经生长因子(NGF)表达,并评估排尿功能(使用膀胱测压法进行尿动力学评估),研究ICH对中枢排尿中枢的影响。结果显示,诱导ICH显著提高了膀胱收缩压力和时间,同时降低了排尿压力和时间。此外,与对照组大鼠相比,诱导ICH的大鼠神经元排尿中枢中的c-Fos和NGF表达水平显著升高。因此,这种ICH诱导的NLUTD大鼠模型可能比脑梗死模型更适合分析中风患者的NLUTD,因为前者更准确地反映了两种类型中风中出血的本质。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/597e/4464363/1605c154b397/MMR-12-02-2563-g00.jpg

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