Ishiura Y
Department of Urology, School of Medicine, Kanazawa University, Japan.
Nihon Hinyokika Gakkai Zasshi. 1996 Nov;87(11):1221-30. doi: 10.5980/jpnjurol1989.87.1221.
Although clinical reports concerning voiding dysfunction after cerebrovascular disease are observed, no experimental studies have been carried out using an animal model. This study was performed to establish an animal model to evaluate neurogenic voiding dysfunction associated with cerebral infarctions.
Male Sprague-Dawley (S-D) rats weighing between 250 to 350 g were used. To induce regional cerebral infarction in rats, 4-0 monofilament nylon thread was introduced through the left internal carotid artery into the origin of the left middle cerebral artery. Cystometric examination was performed in conscious rats through a catheter chronically implanted into the bladder dome. Changes in body weight and bladder capacity were studied. The effects of intravenous oxybutynin hydrochloride, atropine and nifedipine on the conscious rat bladder were examined. By measuring the contractile response to field stimulation with added atropine and alpha, beta-methylene-ATP, the proportion of muscarinergic and purinergic innervation was compared between them.
Bladder capacity in cerebral infarcted rats was significantly decreased just after middle cerebral artery occlusion, and 14, 21 and 28 days after occlusion reached less than half that in sham operated and untreated rats. Bladder capacity correlated with the area of infarcted lesion determined by triphenyltetrazolium chloride staining. In the cerebral infarcted rats, bladder capacity significantly increased at low concentrations of oxybutynin hydrochloride, while in the sham operated rats bladder capacity did not increase. Although an increase in bladder capacity was observed after administration of atropine both in cerebral infarcted and sham operated rats, a significant increase of residual urine was found and considered to be caused by decreased detrusor contraction pressure. Nifedipine increased bladder capacity in the cerebral infarcted rats without increasing residual urine. There was no significant difference in the proportion of muscarinergic and purinergic innervation between the cerebral infarcted and sham operated rats.
These results indicate that calcium channel blocking agents may operate especially on the central nervous system rather than peripheral neuromuscular system, resulting in augmentation of the bladder capacity in the cerebral infarcted rats. Hitherto, the action of oxybutynin hydrochloride on the peripheral neuromuscular system is considered to be the most important, but in the cerebral infarcted rats its action on the central nervous system should also be considered. This type of animal model is believed to be useful to study neurogenic voiding dysfunction of human subjects with cerebrovascular disease.
尽管已有关于脑血管疾病后排尿功能障碍的临床报告,但尚未使用动物模型进行实验研究。本研究旨在建立一种动物模型,以评估与脑梗死相关的神经源性排尿功能障碍。
使用体重在250至350克之间的雄性Sprague-Dawley(S-D)大鼠。为诱导大鼠局部脑梗死,将4-0单丝尼龙线通过左颈内动脉插入左大脑中动脉起始处。通过长期植入膀胱顶部的导管对清醒大鼠进行膀胱测压检查。研究体重和膀胱容量的变化。检查静脉注射盐酸奥昔布宁、阿托品和硝苯地平对清醒大鼠膀胱的影响。通过测量添加阿托品和α,β-亚甲基三磷酸腺苷后对场刺激的收缩反应,比较两者之间毒蕈碱能和嘌呤能神经支配的比例。
大脑中动脉闭塞后即刻,脑梗死大鼠的膀胱容量显著降低,闭塞后14、21和28天降至假手术和未治疗大鼠的一半以下。膀胱容量与通过氯化三苯基四氮唑染色确定的梗死灶面积相关。在脑梗死大鼠中,低浓度盐酸奥昔布宁可使膀胱容量显著增加,而假手术大鼠的膀胱容量未增加。尽管脑梗死大鼠和假手术大鼠在给予阿托品后膀胱容量均增加,但发现残余尿量显著增加,认为这是由逼尿肌收缩压降低所致。硝苯地平可增加脑梗死大鼠的膀胱容量而不增加残余尿量。脑梗死大鼠和假手术大鼠之间毒蕈碱能和嘌呤能神经支配的比例无显著差异。
这些结果表明,钙通道阻滞剂可能主要作用于中枢神经系统而非外周神经肌肉系统,从而导致脑梗死大鼠膀胱容量增加。迄今为止,盐酸奥昔布宁对外周神经肌肉系统的作用被认为是最重要的,但在脑梗死大鼠中,其对中枢神经系统的作用也应予以考虑。这种动物模型被认为有助于研究脑血管疾病患者的神经源性排尿功能障碍。