Kinder R B, Mundy A R
Department of Urology, Leicester General Hospital.
Br J Urol. 1987 Dec;60(6):509-15. doi: 10.1111/j.1464-410x.1987.tb05031.x.
Muscle strips from urodynamically normal bladders and from bladders exhibiting idiopathic detrusor instability or detrusor hyper-reflexia were compared under isometric conditions in an organ bath. Spontaneous contractions developed more often in unstable and hyper-reflexic muscle and were of greater amplitude, frequency and basal tension. Electrical field stimulation caused a frequency-dependent contraction which was largely abolished by both tetrodotoxin (TTX) and atropine in all three muscle types. Comparison of their frequency response curves demonstrated a significantly greater sensitivity than that of unstable and hyper-reflexic muscle to low stimulation frequencies. Acetylcholine caused a dose-related contractile response in all muscle types. There were no significant differences between the dose response curves of unstable and hyper-reflexic muscle, and those of normal muscle. The results suggest that the pathophysiology of the involuntary detrusor contraction is common to both idiopathic detrusor instability and detrusor hyper-reflexia and that this is related to a disorder of an intrinsic neuromodulatory mechanism within the detrusor muscle.
在器官浴槽中，对等长条件下取自尿动力学正常膀胱以及表现为特发性逼尿肌不稳定或逼尿肌反射亢进膀胱的肌肉条进行了比较。自发收缩在不稳定和反射亢进的肌肉中更常出现，且幅度、频率和基础张力更大。电场刺激引起频率依赖性收缩，在所有三种肌肉类型中，这种收缩在很大程度上均被河豚毒素（TTX）和阿托品消除。比较它们的频率反应曲线表明，与不稳定和反射亢进的肌肉相比，正常肌肉对低刺激频率的敏感性显著更高。乙酰胆碱在所有肌肉类型中均引起剂量相关的收缩反应。不稳定和反射亢进肌肉的剂量反应曲线与正常肌肉的剂量反应曲线之间无显著差异。结果表明，特发性逼尿肌不稳定和逼尿肌反射亢进中，逼尿肌非自主性收缩的病理生理学是相同的，且这与逼尿肌内固有神经调节机制紊乱有关。
