不稳定膀胱逼尿肌兴奋性及收缩性改变的实验研究  

Changes of excitability and contractility in detrusor instability

作　　者：卢根生[1] 格次 宋波[1] 金锡御[1] 

机构地区：[1]第三军医大学附属西南医院全军泌尿专科中心,重庆400038 [2]西藏武警总队医院外一科,拉萨850000

出　　处：《第三军医大学学报》2003年第24期2229-2231,共3页Journal of Third Military Medical University

基　　金：国家自然科学基金资助项目 ( 39770 4 71)~~

摘　　要：目的　探讨不稳定膀胱逼尿肌兴奋性、收缩性改变及不稳定膀胱的发病机制。方法　对前列腺增生患者行前列腺摘除术取逼尿肌组织 ,根据尿动力学检查结果分为逼尿肌稳定组 (DS)和逼尿肌不稳定组 (DI) ,各取 8例患者行离体逼尿肌条机械牵拉 ,电及胆碱类药物刺激试验。结果　DI组及DS组逼尿肌条出现收缩时的最小张力分别为 ( 0 3 2 4±0 13 2 )、( 0 82 2± 0 2 16)g ,DI组较DS组明显降低 (P <0 0 5 ) ;逼尿肌条张力为 1 2 5g时 ,DI组及DS组收缩频率分别为( 2 63 7± 1 12 0 )和 ( 1 0 2 1± 0 3 62 )次 min ,DI组较DS组肌条收缩频率明显增大 (P <0 0 5 ) ;DI组与DS组相比 ,电刺激及胆碱类药物刺激逼尿肌条产生的收缩力明显减弱 (P <0 0 5 )。结论　DI逼尿肌兴奋性增高 ,而收缩力明显减弱 。Objectives To observe the changes of the detrusor excitability and contractility and to study the mechanism of the unstable bladder. Methods Detrusor strips were obtained from prostectomy patients with benign prostatic hyperplasia. According to the results of urodynamic examination, patients were divided into detrusor instability (DI) and detrusor stability group(DS). Test of mechanical tension and stimulations with electricity and carbachol were performed on the excitability and contractility of the detrusor strips from 8 patients selected from each of the groups in vitro . Results The minimum tension of the detrusor strips when contraction occurred in DI and DS was (0 324±0 132)g and (0 822±0 216)g, respectively. There was significant difference between DI and DS ( P <0 05). When the detrusor tension was 1 25 g, the contraction frequency of DI detrusor (2 637±1 120) was significantly higher than that of DS (1 021±0 362, P <0 05). Compared with that of the DS, the contraction force of the DI detrusor strips after stimulations with electricity and carbachol decreased significantly( P <0 05). Conclusion In DI detrusor, the excitability increases significantly, but the contraction force decreases significantly. The mechanism of DI is closely related to the myogenic changes of the detrusor.

关 键 词：不稳定膀胱 兴奋性 收缩性 

分 类 号：R322.62[医药卫生—人体解剖和组织胚胎学] R694.502[医药卫生—基础医学]