大鼠脊髓横断后不同时期膀胱Cajal间质细胞变化与膀胱顺应性的关系  

Relationship between the change of bladder interstitial cells of Cajal and bladder compliance post-spinal cord transection at different time points in rats

作　　者：赵耀瑞[1] 李航[3] 郜海涛[2] 刘奔[3] 杨宇明[2] 谢锋 

机构地区：[1]中国人民武装警察部队后勤学院附属医院泌尿外科,天津300162 [2]天津医科大学第二医院泌尿外科天津市泌尿外科研究所,300211 [3]天津医科大学,300070

出　　处：《中华实验外科杂志》2017年第12期2050-2053,共4页Chinese Journal of Experimental Surgery

摘　　要：目的观察大鼠脊髓横断后不同时期膀胱顺应性和膀胱Cajal间质细胞（ICCs）的变化以及甲磺酸伊马替尼对长期脊髓损伤致大鼠神经源性膀胱顺应性的影响。方法将102只雌性Wastar大鼠随机分为假手术6周组（A组）、脊髓横断6周组（B组）、假手术12周组（C组和E组）、脊髓横断12周组（D组和F组）。A～D组用于观察大鼠脊髓横断后不同时期膀胱顺应性和膀胱ICCs的变化，E组和F组用于观察甲磺酸伊马替尼对长期脊髓横断后膀胱顺应性的影响。脊髓横断组行脊髓胸10节段完全横断，假手术组只暴露不横断脊髓。分别于术后6周和12周行尿动力学检查，膀胱标本行免疫荧光染色，观察ICCs数量的变化。E组和F组于术后12周静脉注射不同剂量的甲磺酸伊马替尼，分别于注药前、后行尿动力学检查。结果与对照组比较，B组膀胱顺应性升高[（0.146±0.107） ml/cmH2O比（0.066±0.019） ml/cmH2O，P＝0.017]，膀胱ICCs数量减少[（3.180±1.976）比（4.920±1.564），P＝0.014]；D组膀胱顺应性降低[（0.046±0.023） ml/cmH2O比（0.063±0.013） ml/cmH2O]，膀胱ICCs数量增加[（7.710±2.024）比（4.750±1.138），P＝0.000]。大剂量（20 μmol）甲磺酸伊马替尼可以显著升高对照组大鼠膀胱顺应性[从（0.070±0.029） ml/cmH2O升至（0.096±0.036） ml/cmH2O]；不同剂量（5、20 μmol）甲磺酸伊马替尼均可升高F组膀胱顺应性[从（0.047±0.021） ml/cmH2O分别升至（0.065±0.019） ml/cmH2O和（0.077±0.019） ml/cmH2O，P＝0.000]，且剂量越大作用越强。结论大鼠脊髓横断后，随着时间的延长，膀胱顺应性呈先升高后降低的趋势，对应的膀胱ICCs数量则呈先减少后增多的变化趋势。阻断膀胱ICCs功能可以显著改善长期脊髓高位横断大鼠的膀胱顺应性。脊髓高位横断导致膀胱顺应性减低的病理基础不仅是膀胱纤维化，而且是膀胱ICCs数量增多。ObjectiveTo observe the change of bladder compliance and bladder interstitial cells of Cajal （ICCs） post-suprasacral spinal cord transection at different time points in rats and the effect of Imatinib mesylate on the complicance of neurogenic bladder caused by long-term suprasacral spinal cord transaction in rats.MethodsOne hundred and two female Wistar rats were randomly divided into 6 groups： group A （sham group of 6 weeks）; group B （suprasacral spinal cord transaction group of 6 weeks）; group C and group E （sham group of 12 weeks）; group D and group F （suprasacral spinal cord transaction group of 12 weeks）. The rats in groups A to D were used to study the change of bladder compliance and bladder ICCs post-suprasacral spinal cord transection at different time points. The rats in group E and group F were used to study the effect of Imatinib mesylate on the complicance of neurogenic bladder caused by long-term suprasacral spinal cord transaction. Spinal cord transection at T10 level was built in spinal cord transaction groups, while group A, group C and group F underwent sham operaion. Urodynamics was detected at 6th or 12th week after surgery. We observed the changes of ICCs in the bladder wall by immunohistochemistry. Urodynamics was also detected in group E and group F post-surgery 12 weeks before and after intravenous administration of Imatinib mesylate （5 μmol and 20 μmol respectively）.ResultsThe bladder compliance was significantly increased [（0.146±0.107） ml/cmH2O vs. （0.066±0.019） ml/cmH2O, P=0.017] and the number of ICCs was significantly decreased [（3.180±1.976） vs. （4.920±1.564）, P=0.014] in group B as compared with group A. The bladder compliance was significantly lower [（0.046±0.023） ml/cmH2O vs. （0.063±0.013） ml/cmH2O] and the number of ICCs was significantly higher [（7.710±2.024） vs. （4.750±1.138）, P=0.000] in group D than in group C. The bladder compliance in group E was increased by intravenous administration of 20 μmol Imatinib

关 键 词：脊髓横断 神经源性膀胱 膀胱顺应性 卡尔问质细胞 甲磺酸伊马替尼 

分 类 号：R651.2[医药卫生—外科学] R694[医药卫生—临床医学]