骶神经根磁刺激对神经源性膀胱大鼠膀胱尿流动力学及M3受体表达的影响  

Effect of magnetic stimulation of sacral nerve root on bladder urodynamics and M3 receptor expression in neurogenic bladder rats

作　　者：王彦彬[1] 李瑞鹏[1] 楼扬锋 杨龙飞 季泽益 宋晨[1] WANG Yanbin;LI Ruipeng;LOU Yangfeng;YANG Longfei;JI Zeyi;SONG Chen(Department of Urology,Hangzhou Third People’s Hospital,Hangzhou 310009,China)

机构地区：[1]杭州市第三人民医院泌尿外科,310009 [2]浙江中医药大学研究生院

出　　处：《浙江医学》2020年第24期2619-2622,I0013,共5页Zhejiang Medical Journal

基　　金：浙江省医药卫生科技计划项目(2018PY043);浙江省中医药科技计划项目(2021ZB226);杭州市卫生科技计划项目(0020190678)。

摘　　要：目的探讨骶神经根磁刺激对神经源性膀胱大鼠膀胱尿流动力学及M3受体表达的影响。方法60只雌性成年SD大鼠按随机数字表法分为正常组、模型组、磁刺激组,每组20只。模型组、磁刺激组采用脊髓横断切除法建立神经源性膀胱动物模型。造模成功后,磁刺激组给予磁刺激治疗1次/d,连续治疗8周。8周后,麻醉大鼠行膀胱尿流动力学测定,处死大鼠取膀胱逼尿肌组织行组织学及超微结构观察,并检测M3受体表达水平。结果磁刺激组膀胱最大容量、膀胱顺应性均高于模型组(均P<0.05),漏尿点压力低于模型组(P<0.05);而磁刺激组与正常组上述3个参数比较,差异均无统计学意义(均P>0.05)。磁刺激组膀胱逼尿肌组织HE染色可见浆膜下组织中度充血、水肿,有轻度单核巨噬细胞浸润,并有少量成纤维细胞增生,但黏膜上皮细胞形态及排列较模型组接近正常;在透射电镜下可见逼尿肌细胞表面平滑,细胞间隙稍宽,排列尚均匀,胞质内线粒体结构较完整。磁刺激组大鼠膀胱逼尿肌组织中M3受体表达水平明显高于正常组、模型组(均P<0.05);而模型组与正常组比较,差异无统计学意义(P>0.05)。结论骶神经根磁刺激对神经源性膀胱大鼠的膀胱功能有一定的改善作用,可能与膀胱逼尿肌组织中M3受体表达水平升高有关。Objective To investigate the effect of sacral nerve root magnetic stimulation on bladder urodynamics and M3 receptor expression in neurogenic bladder rats.Methods Sixty female adult SD rats were divided into normal group,model group and magnetic stimulation group according to the random number table method,with 20 rats in each group.The neurogenic bladder animal model was established by spinal cord transection.After the modeling,the magnetic stimulation was given once a day for 8 weeks in magnetic stimulation group.After 8 weeks,the anesthetized rats were subjected to bladder urodynamic measurement,and the rats were sacrificed to take the bladder detrusor tissue for histological and ultrastructural observation,and the expression level of M3 receptor was detected in three groups.Results The maximum bladder volume and bladder compliance of the magnetic stimulation group were higher than those of the model group(all P<0.05),and the bladder leakage point was lower than that of the model group(P<0.05).However,there was no statistically significant difference between the magnetic stimulation group and the normal group in the above three parameters(all P>0.05).HE staining in the magnetic stimulation group showed moderate hyperemia,edema,mild mononuclear macrophage infiltration,and a small amount of fibroblast proliferation in the subserosal tissue,but the morphology and arrangement of mucosal epithelial cells were closer to normal compared with the model group.Transmission electron microscopy showed that the surface of the detrusor muscle cells was smooth,the intercellular spaces were slightly wider, the arrangement was still uniform, and the mitochondrial structure in the cytoplasm was relatively complete. The expression level of M3 receptor in the bladder detrusor tissue of the magnetic stimulation group was significantly higher than that in the normal group and the model group(all P<0.05), while the difference between the model group and the normal group was not statistically significant(P >0.05). Conclusion Magnetic

关 键 词：骶神经根 磁刺激 神经源性膀胱 尿流动力学 M3受体 

分 类 号：R694[医药卫生—泌尿科学]