CAJ | 학술논문

目的探讨早期骶3神经电调节在大鼠脊髓损伤后神经源性膀胱治疗中的应用及可能作用机制。方法将45只雌性成年SD大鼠随机分为正常组、电针治疗组、电针对照组，每组15只。采用脊髓横断法建立大鼠神经源性膀胱的模型。电针对照组与电针治疗组造模成功后均进行电极植入；电针治疗组进行电调节治疗，1次/d，连续治疗4周；正常组常规饲养。3组大鼠在电针治疗组治疗4周后均行尿动力学测定，同时处死取材，采用免疫荧光定量PCR方法测定M3受体mRNA表达水平。结果尿动力学结果显示在膀胱最大容量、膀胱漏尿点压、膀胱顺应性指标中，电针治疗组与电针对照组比较，差异有统计学意义（P＜0.05）。荧光定量PCR结果显示，电针治疗组膀胱M3R的mRNA含量明显高于电针对照组和正常组，差异有统计学意义（P＜0.05或0.01）。结论早期骶3神经电调节可以明显改善脊髓损伤后神经源性膀胱储尿和排尿功能的恢复，其作用机制可能是电调节促进脊髓损伤早期膀胱逼尿肌组织中M3R的高表达，抑制逼尿肌纤维化，改善膀胱顺应性。
목적탐토조기저3신경전조절재대서척수손상후신경원성방광치료중적응용급가능작용궤제。방법장45지자성성년SD대서수궤분위정상조、전침치료조、전침대조조，매조15지。채용척수횡단법건립대서신경원성방광적모형。전침대조조여전침치료조조모성공후균진행전겁식입；전침치료조진행전조절치료，1차/d，련속치료4주；정상조상규사양。3조대서재전침치료조치료4주후균행뇨동역학측정，동시처사취재，채용면역형광정량PCR방법측정M3수체mRNA표체수평。결과뇨동역학결과현시재방광최대용량、방광루뇨점압、방광순응성지표중，전침치료조여전침대조조비교，차이유통계학의의（P＜0.05）。형광정량PCR결과현시，전침치료조방광M3R적mRNA함량명현고우전침대조조화정상조，차이유통계학의의（P＜0.05혹0.01）。결론조기저3신경전조절가이명현개선척수손상후신경원성방광저뇨화배뇨공능적회복，기작용궤제가능시전조절촉진척수손상조기방광핍뇨기조직중M3R적고표체，억제핍뇨기섬유화，개선방광순응성。
Objective To investigate the efficacy of early stimulation of sacral the 3 for treatment of neurogenic bladder in rats. Methods Forty five adult female SD rats were randomly divided into 3 groups with 15 in each: normal group (A), sham stimulation group (B) and electro- acupuncture group (C). The neurogenic bladder was induced by spinal cord transection and then the electrode was implanted in group B and C. Rats in group C received electric stimulation twice/d for 4w. The urodynamic measurement was performed after 4w in al 3 groups, the rats were sacrificed and the expression of M3 receptor mRNA in detru-sor tissue was measured by immunofluorescence quantitative PCR method. Results The urodynamic results showed that there were no significant differences in maximum bladder capacity, bladder leak point pressure, bladder compliance indicators be-tween group C and group A (P>0.05), but there were significant differences between group C and group B(P<0.05). PCR results showed that the expression of M3R mRNA in group C was significantly higher than that in group A and group B(P<0.01 or<0.05). Conclusion The early sacral nerve electrical stimulation can improve the storage and voiding function of neurogenic bladder after spinal cord injury, which may be associated with up- regulation of M3R in detrusor tissue, inhibition of detrusor fibrosis and im-provement of bladder compliance.