CAJ | 학술논문

目的：探讨低剂量紫杉醇对膀胱出口部分梗阻（ BOO）大鼠膀胱形态变化的影响。方法：健康雌性Sprague-Dawley大鼠30只，随机分为空白对照组、BOO组和紫杉醇组。 BOO组和紫杉醇组行尿道近端梗阻方式制备膀胱出口部分梗阻模型，空白对照组采用假手术方式处理。紫杉醇组于术后给予紫杉醇（溶于生理盐水）腹腔注射（0．3 mg/kg），每周2次。空白对照组与BOO组以等体积生理盐水同时间腹腔注射。4周后测量体重及膀胱重量，HE染色观察膀胱肌层增生情况；Masson三色染色观察并评价胶原纤维沉积；透射电镜观察逼尿肌超微结构改变。结果：与空白对照组相比，BOO组膀胱重量明显增加（0．376 g ±0．052 g vs 0．112 g ±0．014 g， P＜0．05），膀胱逼尿肌明显增厚，胶原纤维面积占胶原与肌组织面积之和的比值下降（29．66％±2．69％ vs 38．94％±3．67％， P＜0．05），电镜下细胞中间连接明显减少，出现丰富的突触连接与桥粒连接，肌细胞间隙内有大量的胶原纤维。与BOO组相比，紫杉醇组膀胱重量显著降低（0．215 g ±0．025 g vs 0．376 g ±0．052 g， P＜0．05），膀胱逼尿肌厚度减小，胶原纤维染色面积占胶原与肌组织面积之和的比值下降（19．94％±1．90％vs 29．66％±2．69％， P＜0．05），细胞间连接以中间连接为主，细胞间隙内胶原纤维减少。结论：低剂量紫杉醇对BOO后膀胱形态结构的变化有一定的修复或逆转作用。
목적：탐토저제량자삼순대방광출구부분경조（ BOO）대서방광형태변화적영향。방법：건강자성Sprague-Dawley대서30지，수궤분위공백대조조、BOO조화자삼순조。 BOO조화자삼순조행뇨도근단경조방식제비방광출구부분경조모형，공백대조조채용가수술방식처리。자삼순조우술후급여자삼순（용우생리염수）복강주사（0．3 mg/kg），매주2차。공백대조조여BOO조이등체적생리염수동시간복강주사。4주후측량체중급방광중량，HE염색관찰방광기층증생정황；Masson삼색염색관찰병평개효원섬유침적；투사전경관찰핍뇨기초미결구개변。결과：여공백대조조상비，BOO조방광중량명현증가（0．376 g ±0．052 g vs 0．112 g ±0．014 g， P＜0．05），방광핍뇨기명현증후，효원섬유면적점효원여기조직면적지화적비치하강（29．66％±2．69％ vs 38．94％±3．67％， P＜0．05），전경하세포중간련접명현감소，출현봉부적돌촉련접여교립련접，기세포간극내유대량적효원섬유。여BOO조상비，자삼순조방광중량현저강저（0．215 g ±0．025 g vs 0．376 g ±0．052 g， P＜0．05），방광핍뇨기후도감소，효원섬유염색면적점효원여기조직면적지화적비치하강（19．94％±1．90％vs 29．66％±2．69％， P＜0．05），세포간련접이중간련접위주，세포간극내효원섬유감소。결론：저제량자삼순대BOO후방광형태결구적변화유일정적수복혹역전작용。
AIM: To investigate the effects of low-dose paclitaxel on the morphology of bladder after partial bladder outlet obstruction ( BOO) in rats.METHODS:Healthy female Sprague-Dawley rats ( n=30) were randomly di-vided into sham operation group, BOO group and low-dose paclitaxel group.The rats in BOO group and low-dose paclitaxel group received operation to establish an obstruction model, while the rats in sham group underwent sham operation.After operation, the rats in low-dose paclitaxel group received intraperitoneal injection of paclitaxel at a dose of 0.3 mg/kg twice a week for 4 weeks.At the same time, the animals in sham group and BOO group received the same volume of saline by in-traperitoneal injection.Four weeks after operation, each rat was sedated and the bladder was weighted.Histological chan-ges of the bladder were observed by HE staining.Collagen deposition in the bladder tissue was observed by Masson stai-ning, and the fibrosis area was measured.The ultrastructure of the detrusor was studied by transmission electron microsco-py.RESULTS:Compared with sham operation group, a significant increase in bladder weight (0.376 g ±0.052 g vs 0.112 g ±0.014 g, P<0.05), the muscle hypertrophy, and a decrease in the percentage of collagen area [collagen/(col-lagen+muscle), 29.66%±2.69%vs 38.94%±3.67%, P<0.05] was observed in BOO group.Under electron micro-scope, intracellular connection had more gap junction and desmosomes than intermediate junction.The cell gap widened with a large amount of collagen fiber.Compared with BOO group, low-dose paclitaxel group decreased bladder weight (0.215 g ±0.025 g vs 0.376 g ±0.052 g, P<0.05) and improved the muscle hypertrophy.The percentage of the colla-gen area was also decreased (19.94%±1.90% vs 29.66%±2.69%, P<0.05).The detrusor microstructure showed that the intermediate junction was characterized by a predominance among the intracellular connections, and the intercellu-lar space contained less collagen fibers in low-dose paclitaxel group.CONCLUSION:Low-dose paclitaxel may ameliorate the morphological damage of the bladder and recover bladder function in the rats with BOO by slowing down the process of bladder fibrosis.