Pedersen E, Tørring J, Klemar B
Acta Neurol Scand. 1980 Feb;61(2):107-14. doi: 10.1111/j.1600-0404.1980.tb01472.x.
The effect of the alpha-adrenergic blocking agent thymoxamine by intravenous administration was studied in 25 patients with spastic paraplegia and uninhibited neurogenic bladder. By cystometry a shift to the right of the first desire to void, the threshold of the first uninhibited contraction and a reduction of the pressures of the uninhibited contractions was found, but the bladder capacity was unchanged. The urethral pressure profile studied in 10 patients showed reduction in most and the peak value in all the patients. EMG from the external urethral sphincter in five patients showed damping of anal reflexes in all cases and in basic activity and cough reflexes when appropriate for studies. The site of action on the bladder is most likely adrenergic receptors in the bladder and the unchanged bladder capacity may be related to a too-short duration of the effect of thymoxamine. The effect on the spastic striated pelvic sphincters may be central, whereas the effect on the smooth muscle may be peripheral. Feedback from the drug relaxed proximal part of the urethra to the bladder might also be of importance.
对25例痉挛性截瘫合并无抑制性神经源性膀胱患者进行了静脉注射α-肾上腺素能阻滞剂百里胺的效果研究。通过膀胱测压发现，首次排尿欲望、首次无抑制性收缩阈值向右偏移，无抑制性收缩压力降低，但膀胱容量未变。对10例患者进行的尿道压力分布图研究显示，大多数患者的压力降低，所有患者的峰值均降低。对5例患者尿道外括约肌的肌电图研究显示，在所有病例中肛门反射均减弱，在基础活动和咳嗽反射时（适合进行研究时）也减弱。百里胺对膀胱的作用部位很可能是膀胱中的肾上腺素能受体，膀胱容量未变可能与百里胺作用持续时间过短有关。其对痉挛性横纹肌骨盆括约肌的作用可能是中枢性的，而对平滑肌的作用可能是外周性的。药物使尿道近端松弛并反馈至膀胱这一点可能也很重要。
