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膀胱出口梗阻对兔逼尿肌收缩力及被动特性的影响。

Effect of vesical outlet obstruction on detrusor contractility and passive properties in rabbits.

作者信息

Ghoniem G M, Regnier C H, Biancani P, Johnson L, Susset J G

出版信息

J Urol. 1986 Jun;135(6):1284-9. doi: 10.1016/s0022-5347(17)46075-7.

Abstract

Outlet obstruction was induced in 16 New Zealand rabbits by implanting a polyethylene tube (20 F) for a period of three months. The tube was slit longitudinally and placed around the bladder neck, between the ureters and vasa deferentia. It was left open to induce moderate obstruction and closed by a suture to induce severe obstruction. The animals were studied by cutting consecutive rings from each bladder, which were subjected to the following studies: morphology, contractility and mechanical properties. Morphology. Histology sections of the rings, studied by Hematoxylin and Eosin and Masson-Trichrome stains, demonstrated smooth muscle hypertrophy in moderate obstruction, while hyperplasia was the predominant response in severe obstruction. The average nuclear count per square millimeter of smooth muscle was 251 in controls, 87 in moderate obstruction and 705 in severe obstruction. Bladder wall thickness was significantly increased after both moderate and severe obstruction, as compared to controls. Contractility and mechanical properties. Each ring was tested in a muscle chamber under conditions of maximal electrical stimulation (100 V, 2 ms, 40 Hz). For each ring, full force-length relationships (active and passive) were obtained by stretching the rings in successive increments until length of maximal active force development was reached. Force was normalized per unit cross-sectional area (stress), and length according to a "reference" underformed state (per cent of unloaded length). The maximum active stress of the rings was taken as a measure of bladder contractility, and the rate of increase in passive force as a measure of detrusor stiffness. In all groups, the body of the detrusor exerted better contractility, as compared to a rigid, less contractile base. In the obstructed groups, detrusor contractility was significantly decreased at the body level, with increased stiffness, as compared to controls. The length at which maximum contractility was exerted, however, increased in moderate obstruction, and decreased in severe obstruction.

摘要

通过植入一根聚乙烯管(20F),对16只新西兰兔造成出口梗阻,持续三个月。将管子纵向切开,置于膀胱颈周围,位于输尿管和输精管之间。管子敞开以造成中度梗阻,通过缝合封闭以造成重度梗阻。通过从每个膀胱切取连续的环来对动物进行研究,这些环进行以下研究:形态学、收缩性和力学性能。形态学。通过苏木精-伊红染色和马松三色染色研究环的组织学切片,结果显示中度梗阻时平滑肌肥大,而重度梗阻时增生是主要反应。对照组每平方毫米平滑肌的平均核计数为251,中度梗阻时为87,重度梗阻时为705。与对照组相比,中度和重度梗阻后膀胱壁厚度均显著增加。收缩性和力学性能。每个环在肌肉腔中于最大电刺激(100V,2ms,40Hz)条件下进行测试。对于每个环,通过连续递增拉伸环直至达到最大主动力发展长度,获得完整的力-长度关系(主动和被动)。力按单位横截面积(应力)进行归一化,长度根据“参考”未变形状态(未加载长度的百分比)进行归一化。环的最大主动应力用作膀胱收缩性的指标,被动力增加率用作逼尿肌僵硬度的指标。在所有组中,与僵硬、收缩性较差的底部相比,逼尿肌主体表现出更好的收缩性。在梗阻组中,与对照组相比,逼尿肌在主体水平的收缩性显著降低,僵硬度增加。然而,产生最大收缩性的长度在中度梗阻时增加,在重度梗阻时减少。

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