Saito M, Kondo A, Kato T, Miyake K
Department of Urology, Nagoya University School of Medicine.
Nihon Hinyokika Gakkai Zasshi. 1993 Mar;84(3):507-13. doi: 10.5980/jpnjurol1989.84.507.
The detrusor contraction induced by intramural nerve stimulation in human neurogenic bladders was investigated in comparison with control bladders. All the cases with the neurogenic bladder underwent ileocystoplasty in order to resolve intractable incontinence and/or vesicoureteral reflux due to low bladder compliance or severe detrusor uninhibited contraction. 1. The dose-response curve and ED50 value for KCl were not different between neurogenic and control bladders. 2. The response of neurogenic bladders induced by intramural stimulation was significantly stronger than that of control bladders. 3. After application of 10(-6) M atropine remaining contraction of neurogenic bladders was significantly greater than that of control bladders, i.e. 28.4% and 3.7% respectively. However, 10(-6) M tetrodotoxin almost completely inhibited the detrusor contraction in both groups. 4. The subthreshold KCl (5 mM or 10 mM) enhanced the detrusor contractility significantly in control bladders compared to neurogenic bladders. 5. After bathing medium was replaced into Ca-free Krebs' solution, the contractile response was decreased. The contraction of neurogenic bladders in Ca-free solution persisted longer than that of controls. In conclusion, though there was no intrinsic difference in detrusor contractility, contractile response to electrical field stimulation, atropine resistance, enhancement of response by potassium, and contractility in Ca-free solution were significantly different between neurogenic and control bladders.
将人类神经源性膀胱壁内神经刺激诱导的逼尿肌收缩与对照膀胱进行了比较研究。所有神经源性膀胱病例均接受了回肠膀胱扩大术，以解决由于膀胱顺应性低或逼尿肌无抑制性收缩导致的顽固性尿失禁和/或膀胱输尿管反流问题。1. 神经源性膀胱和对照膀胱对氯化钾的剂量-反应曲线及半数有效量值无差异。2. 壁内刺激诱导的神经源性膀胱反应明显强于对照膀胱。3. 应用10(-6)M阿托品后，神经源性膀胱的残余收缩明显大于对照膀胱，分别为28.4%和3.7%。然而，10(-6)M河豚毒素几乎完全抑制了两组的逼尿肌收缩。4. 与神经源性膀胱相比，阈下氯化钾(5mM或10mM)显著增强了对照膀胱的逼尿肌收缩力。5. 将灌流液换成无钙的克雷布斯溶液后，收缩反应降低。无钙溶液中神经源性膀胱的收缩持续时间比对照组长。总之，尽管逼尿肌收缩力没有内在差异，但神经源性膀胱和对照膀胱在对电场刺激的收缩反应、阿托品抵抗、钾对反应的增强作用以及无钙溶液中的收缩力方面存在显著差异。
