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目的探讨钙激活钾通道和氯通道对逼尿肌条收缩的调节在逼尿肌不稳定发生中的作用。方法建立Wistar大鼠逼尿肌不稳定模型,设正常对照组,利用逼尿肌条体外实验,观察阻断与开放通道后肌条的收缩频率和动力指数变化及差异。结果对照组与不稳定组肌条收缩频率分别为(2.3±0.5)次/min和(4.1±0.9)次/min,动力指数分别为31.3±6.1和59.5±7.8,2组比较差异有统计学意义(P<0.01)。2组逼尿肌条的收缩频率和动力指数在钙激活钾通道阻断与开放前后的增加或下降变化均有统计学意义(P<0.05),其中对照组大电导钙激活钾通道阻断后频率下降(23±10)%,不稳定组增加(29±10)%,2组动力指数分别增加(24±5)%和(16±5)%,通道开放后频率分别下降(34±7)%和(23±9)%,动力指数分别下降(32±9)%和(23±7)%。2组小电导钙激活钾通道阻断后频率分别增加(77±16)%和(27±10)%,动力指数分别增加(81±12)%和(52±14)%,通道开放后频率分别下降(49±6)%和(35±7)%,动力指数分别下降(55±8)%和(32±12)%。2组钾通道阻断或开放前后变化幅度的差异有统计学意义(P<0.01)。对照组阻断钙激活氯通道后收缩频率及动力指数下降(9±20)%和(8±9)%(P>0.05),不稳定组分别下降(44±17)%和(50±12)%(P<0.01),2组变化幅度差异有统计学意义(P<0.01)。结论钙激活钾通道和氯通道反馈调节逼尿肌收缩功能,钾通道作用下降和氯通道作用增强可能是导致梗阻性逼尿肌不稳定的重要原因之一。
Objective To investigate the role of calcium-activated potassium channel and chloride channel in the regulation of detrusor contraction in detrusor instability. Methods Detrusor instability model was established in Wistar rats. A normal control group was established. The in vitro experiments of detrusor strips were used to observe the changes of contractile frequency and dynamic index of muscle strips after blocking and opening channels. Results The systolic frequency of myotubes in control group and unstable group were (2.3 ± 0.5) times / min and (4.1 ± 0.9) times / min respectively, and the dynamic indexes were 31.3 ± 6.1 and 59.5 ± 7.8 respectively. There were statistically significant differences between the two groups Significance (P <0.01). The contractile frequency and dynamic index of detrusor strips in both groups were significantly increased (P <0.05) after calcium-activated potassium channel blockade and before and after the opening (23 ± 10)% in the unstable group, (29 ± 10)% in the unstable group, and (24 ± 5)% and (16 ± 5)% in the 2 groups respectively ) And (23 ± 9)% respectively, and the dynamic index decreased by (32 ± 9)% and (23 ± 7)% respectively. The frequency of blockade of the two groups of small conductance calcium-activated potassium channel increased by (77 ± 16)% and (27 ± 10)%, and the dynamic index increased by (81 ± 12)% and (52 ± 14)% respectively Decreased by (49 ± 6)% and (35 ± 7)% respectively, and the motor index decreased by (55 ± 8)% and (32 ± 12)% respectively. There was significant difference between the two groups in the change of potassium channel before or after the blockade or opening (P <0.01). The contractile frequency and motor index decreased (9 ± 20)% and (8 ± 9)% in control group (44 ± 17)% and (50 ± 12), respectively )% (P <0.01). There was significant difference between the two groups (P <0.01). Conclusions Calcium - activated potassium channel and chloride channel can regulate the contractile function of detrusor muscle. The decrease of potassium channel and the increase of chloride channel may be one of the important causes of instability of obstructive detrusor.