CAJ | 학술논문

目的观察膀胱缺血情况下膀胱出口部分梗阻兔膀胱组织形态及酶学变化情况,探讨膀胱缺血对膀胱出口部分梗阻后膀胱病变的影响.方法 64只成年新西兰兔电脑随机分为4组,每组16只.采用半缝扎腹主动脉制造膀胱缺血动物模型,采用部分结扎膀胱出口制造膀胱出口部分梗阻动物模型.每组中随机选择4只行膀胱缺血手术(缺血组),4只行膀胱出口部分梗阻手术(梗阻组),4只行膀胱缺血及膀胱出口部分梗阻手术(联合组),4只为假手术对照组.于术后第1、2、4、8周各取l组测量膀胱湿重,然后膀胱全层石蜡切片MASSON染色观察黏膜层、黏膜下层、肌层及浆膜层厚度并分析膀胱间质平滑肌与胶原成分含量变化,S-100染色分析组织内神经元变化情况.检测膀胱肌层组织中肌浆网钙ATP酶与柠檬酸盐合酶活性.结果梗阻组与联合组兔膀胱重量自术后1周开始增加,分别为(5.10±0.29)、(4.80±0.37)g,均高于对照组[(1.93±0.17)g,均P＜0.05];在术后第4周达到最大值分别为( 18.48±2.03)与(12.35±0.39)g,同期梗阻组膀胱重量大于联合组(P＜0.05).梗阻组在处置前4周主要表现为肌层组织代偿性增厚,4周后出现纤维组织及胶原成分增加,而联合组处置后即出现肌层和纤维组织及胶原成分增加,2周后主要为纤维组织及胶原成分增加.S-100染色分析显示,与对照组相比,所有处理组兔膀胱组织内均出现了不同程度的神经缺失,以联合组尤为明显.梗阻组兔膀胱平滑肌肌浆网钙ATP酶与柠檬酸盐合酶活性在术后第4周达最大值,术后第8周降至低于术后第1周水平;联合组术后第1周两种酶活性开始持续下降;同期对照组两种酶活性均高于梗阻组和联合组(均P ＜0.05).结论膀胱缺血可降低膀胱对梗阻的耐受力,加重膀胱功能的损害.
목적 관찰방광결혈정황하방광출구부분경조토방광조직형태급매학변화정황,탐토방광결혈대방광출구부분경조후방광병변적영향.방법 64지성년신서란토전뇌수궤분위4조,매조16지.채용반봉찰복주동맥제조방광결혈동물모형,채용부분결찰방광출구제조방광출구부분경조동물모형.매조중수궤선택4지행방광결혈수술(결혈조),4지행방광출구부분경조수술(경조조),4지행방광결혈급방광출구부분경조수술(연합조),4지위가수술대조조.우술후제1、2、4、8주각취l조측량방광습중,연후방광전층석사절편MASSON염색관찰점막층、점막하층、기층급장막층후도병분석방광간질평활기여효원성분함량변화,S-100염색분석조직내신경원변화정황.검측방광기층조직중기장망개ATP매여저몽산염합매활성.결과 경조조여연합조토방광중량자술후1주개시증가,분별위(5.10±0.29)、(4.80±0.37)g,균고우대조조[(1.93±0.17)g,균P＜0.05];재술후제4주체도최대치분별위( 18.48±2.03)여(12.35±0.39)g,동기경조조방광중량대우연합조(P＜0.05).경조조재처치전4주주요표현위기층조직대상성증후,4주후출현섬유조직급효원성분증가,이연합조처치후즉출현기층화섬유조직급효원성분증가,2주후주요위섬유조직급효원성분증가.S-100염색분석현시,여대조조상비,소유처리조토방광조직내균출현료불동정도적신경결실,이연합조우위명현.경조조토방광평활기기장망개ATP매여저몽산염합매활성재술후제4주체최대치,술후제8주강지저우술후제1주수평;연합조술후제1주량충매활성개시지속하강;동기대조조량충매활성균고우경조조화연합조(균P ＜0.05).결론 방광결혈가강저방광대경조적내수력,가중방광공능적손해.
Objective To compare the structures and functions of rabbit bladder after partial bladder outlet obstruction versus without ischemia so as to explore the effects of ischemia on bladder pathogenesis in rabbits with partial bladder outlet obstruction.Methods A total of 64 mature male rabbits were divided into 4 groups (n =16 each).Four of each group underwent operation to establish an ischemie animal model ( ischemia group ),another 4 underwent operation to establish a partial bladder outlet obstruction animal model ( obstruct group),the other 4 underwent operation to establish an ischemic and partial bladder outlet obstruction animal model (combination group) and the remaining 4 underwent a sham operation as control.The rabbits in 4 groups were evaluated at Week 1,2,4 and 8 post-operation respectively.The weight of bladder,the thickness of mucosal,submucosa,muscular layer and placenta percreta and the activities of sarco/endoplasmic reticulum Ca2+ ATPase citrate synthase of cystic smooth muscle were detected respectively.MASSON staining was used to observe the smooth muscle and collagen in stroma of bladder and S-100 staining for observing the neurons in bladder.Results In obstruct and combination groups,the weights of bladder at week 1 were ( 5.10 ± 0.29 ) g and ( 4.80 ± 0.37 ) g respectively.They were both significantly higher than control group[ ( 1.93 +0.17) g,all P ＜0.05].The weights of bladder in obstruct and combination groups peaked at Week 4 and they were (18.48 + 2.03 ) g and ( 12.35 ±0.39) g respectively.The weight of bladder in obstruct group was significantly heavier than combination group in the same terms.And they were both significantly heavier than control and ischemia groups(all P ＜ 0.05 ).Muscular tissue vicariously thickened during the first 4 weeks,and collagen and stroma increased at Week 4 in obstruct group.Muscular tissue,collagen and stroma all increased initially.But at Week 2 only collagen and stroma increased in combination group.Compare with control group,the other groups all have deletion of neurons,especially in combination group.The activities of sarco/endoplasmic reticulum Ca2 + ATPase and citrate synthase of cystic smooth muscle of obstruct group peaked at Week 4.In combination group,the activities of sarco/endoplasmic reticulum Ca2+ ATPase and citrate synthase of cystic smooth muscle were decreased over 2 -8 weeks.In the same terms,the activities of sarco/endoplasmic reticulum Ca2+ ATPase and citrate synthase of cystic smooth muscle in control group were significantly higher than those in obstruct and combination groups ( all P ＜ 0.05 ).Conclusion Ischemia can reduce the tolerance of bladder and aggravate the impairment of bladder to partial outlet obstruction.