Sundin T, Dahlström A, Norlén L, Svedmyr N
Invest Urol. 1977 Jan;14(4):322-8.
Adrenergic innervation of the human urinary bladder was studied in vitro in specimens excised during operation from six neurologically normal bladders and from five parasympathetically denervated (lower motor neuron lesion) bladders. Using a specific histochemical fluorescence technique, it was found that the adrenergic nerve terminals of the detrusor of the patients with lower motor neuron lesions were thicker, had a stronger fluorescence intensity, and were in most cases also more densely distributed than those of any of the six neurologically normal bladders examined. By recording the changes in the isometric tension of detrusor strips after different pharmacologic treatments, the existence of alpha-adrenergic receptors could be demonstrated in the parasympathetically denervated detrusor but not in the normal detrusor. The influence of alpha-adrenolytic treatment (phenoxybenzamine) was studied in vivo in seven patients with lower motor neuron lesions. In the cystometrograms, the bladders were more hypotonic and the "autonomous waves" appeared at a higher level of filling or were totally extinguished after this pharmacologic treatment. With an isotonic volume registration method, a bladder volume increase was recorded after alpha-adrenergic blockade. Using sphincterometry or urethral pressure profile studies, a decrease in the urethral resistance was observed after alpha-adrenolytic treatment.
在体外对人体膀胱的肾上腺素能神经支配进行了研究，所用标本取自6个神经功能正常的膀胱和5个副交感神经去神经支配（下运动神经元损伤）的膀胱，这些标本均在手术中切除。采用特定的组织化学荧光技术发现，下运动神经元损伤患者逼尿肌的肾上腺素能神经末梢更粗，荧光强度更强，且在大多数情况下，其分布密度也高于所检查的6个神经功能正常的膀胱中的任何一个。通过记录不同药物处理后逼尿肌条等长张力的变化，可证明在副交感神经去神经支配的逼尿肌中存在α - 肾上腺素能受体，而正常逼尿肌中不存在。在7名下运动神经元损伤患者体内研究了α - 肾上腺素能阻断治疗（酚苄明）的影响。在膀胱压力容积图中，膀胱张力更低，“自主性波”在更高的充盈水平出现，或在这种药物治疗后完全消失。采用等容容积记录法，记录到α - 肾上腺素能阻断后膀胱容积增加。通过括约肌测量或尿道压力分布研究，观察到α - 肾上腺素能阻断治疗后尿道阻力降低。
