CAJ | 학술논문

目的：观察骶3神经电调节对脊髓损伤早期大鼠逼尿肌细胞凋亡及膀胱纤维化影响。方法取雌性成年SD大鼠90只，随机分成实验组60只，空白对照组30只，采用脊髓横断法建立大鼠神经源性膀胱的模型。实验组大鼠随机分为电针组及阴性对照组，各30只。电针组进行电极植入，并行电调节治疗2周。3组大鼠2周后同时处死取材，均分别采用胶原染色、苦杏酸天狼星红染色、免疫组化方法来观察逼尿肌纤维化程度。采用透射电镜观察逼尿肌细胞超微结构改变。结果①胶原染色及苦杏酸天狼星红染色观察，电针组同阴性对照组相比，平滑肌细胞之间胶原纤维的数量明显减少，细胞排列规则。②电针组膀胱组织Collagen Ⅰ和Collagen Ⅲ表达分别为（1.042±0.213）、（1.532±0.141），均明显低于阴性对照组的（2.049±0.246）、（3.901±0.208），电针组Ⅰ/Ⅲ型胶原比例较阴性对照组明显减少，差异有统计学意义（P<0.05）。阴性对照组CollagenⅠ和CollagenⅢ表达显著高于空白对照组的（1.154±0.124）、（0.780±0.127），阴性对照组Ⅰ/Ⅲ型胶原比例较空白对照组明显增高，差异有统计学意义（P<0.05）。③电镜观察，电针组与阴性对照组相比，逼尿肌细胞表面平滑，排列均匀，胞浆内线粒体结构完整，无肿胀破裂现象，细胞结构接近于空白对照组。结论骶3神经电调节能抑制脊髓损伤早期大鼠膀胱逼尿肌间质中胶原纤维的表达，减少脊髓损伤后大鼠逼尿肌细胞的凋亡，促进膀胱功能恢复。
목적：관찰저3신경전조절대척수손상조기대서핍뇨기세포조망급방광섬유화영향。방법취자성성년SD대서90지，수궤분성실험조60지，공백대조조30지，채용척수횡단법건립대서신경원성방광적모형。실험조대서수궤분위전침조급음성대조조，각30지。전침조진행전겁식입，병행전조절치료2주。3조대서2주후동시처사취재，균분별채용효원염색、고행산천랑성홍염색、면역조화방법래관찰핍뇨기섬유화정도。채용투사전경관찰핍뇨기세포초미결구개변。결과①효원염색급고행산천랑성홍염색관찰，전침조동음성대조조상비，평활기세포지간효원섬유적수량명현감소，세포배렬규칙。②전침조방광조직Collagen Ⅰ화Collagen Ⅲ표체분별위（1.042±0.213）、（1.532±0.141），균명현저우음성대조조적（2.049±0.246）、（3.901±0.208），전침조Ⅰ/Ⅲ형효원비례교음성대조조명현감소，차이유통계학의의（P<0.05）。음성대조조CollagenⅠ화CollagenⅢ표체현저고우공백대조조적（1.154±0.124）、（0.780±0.127），음성대조조Ⅰ/Ⅲ형효원비례교공백대조조명현증고，차이유통계학의의（P<0.05）。③전경관찰，전침조여음성대조조상비，핍뇨기세포표면평활，배렬균균，포장내선립체결구완정，무종창파렬현상，세포결구접근우공백대조조。결론저3신경전조절능억제척수손상조기대서방광핍뇨기간질중효원섬유적표체，감소척수손상후대서핍뇨기세포적조망，촉진방광공능회복。
Objective To investigate sacral nerve stimulation through S3 foramen for the treatment of detrusor cell apoptosis and neurogenic fibrosis of the bladder in rats with spinal cord injury(SCI). Methods Ninety SD fe-male rats were randomly divided into experimental group (n=30), control group (n=30), blank group (n=30). SCI model was established by crosscutting spine. Rats in experimental group were implanted with electrical acupuncture poles and had neruomodulation for 2 weeks. Rats in 3 groups were all sacrificed at the end of nerve stimulation and immunohistochemistry, collagen staining and Sirius Red F3B(SR) staining and transmission electron microscope (TEM) were used to observe the apoptosis and fibrosis of the detrusor muscle. Results Collagen and SR staining showed that less collagen fiber was seen between detrusor cells and the cells were more regular and smooth in ex-perimental group than those in control group. Collagen I and collagen III were decreased in experimental group than those in control group (collagen I:1.042±0.213 vs 2.049±0.246, collagen III:1.532±0.141 vs 3.901±0.208, P<0.05). The ratio of collagen I to collagen III in experimental group was lower than that in control group with sig-nificant difference (P<0.05). The collagen I and collagen III of control group was higher than that of blank group (collagen I:1.154±0.124, collagen III:0.780±0.127, P<0.05) and the ratio of collagen I to collagen III was also higher (P<0.05). TEM observed that the cells of experimental group were more regular and smoother than those of control group and no cell edema and destroied and the construction of the cells were similar to the normal cells (blank group). Conclusion The S3 nerve electrical stimulation may improve bladder function by inhibiting apopto-sis and fibrosis of detrusor cells in SCI rats.