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目的观察体神经—内脏神经人工反射弧建立后,大鼠膀胱肌间神经丛分布的改变以及神经肌肉接头处的变化。方法Sprague-Dawley大鼠随机分为三组:对照组、脊髓横断组和手术重建组。手术重建组大鼠术后饲养3个月,与脊髓横断组大鼠一起进行脊髓横断,再继续饲养3个月,对照组不做任何处理。DiI进行逆行神经追踪;免疫荧光的方法显示DiI阳性标记细胞中的胆碱乙酰转移酶(choline acetyltransferase,ChAT);改良的Karnovsky-Roots法检测膀胱铺片中神经纤维的分布。结果DiI阳性标记细胞主要分布于脊髓L3尾部至L5头侧前角,ChAT阳性细胞和DiI阳性标记细胞部分重叠。手术重建组和对照组相比,膀胱肌间神经纤维的数量较少,染色浓度也较浅(P<0.05);而手术重建组神经纤维密度较脊髓横断组增大,染色浓度增强(P<0.05),且出现明显的神经再分布。结论人工体内脏神经反射弧建立后,新的传出支为体神经,可以长入副交感神经纤维,传出神经元的递质仍为乙酰胆碱,膀胱内胆碱能神经纤维再生和乙酰胆碱活性增强且出现神经再分布,这可能在膀胱的控制性排尿中起作用。
Objective To observe the distribution of myenteric plexus in the bladder and the changes of neuromuscular junctions after the establishment of artificial reflex arc of somatic-visceral nerve. Methods Sprague-Dawley rats were randomly divided into three groups: control group, spinal cord transection group and surgical reconstruction group. The rats in the reconstructive surgery group were kept for 3 months postoperatively, and the spinal cord transected with the transected spinal cord rats for another 3 months. The rats in the control group received no treatment. DiI for retrograde nerve tracking; Immunofluorescence staining showed ChI acetylcholinesterase (ChAT) in DiI-positive cells; Karnovsky-Roots method was used to detect the distribution of nerve fibers in the bladder patch. Results The DiI positive labeled cells mainly distributed in the anterior horn of the L3 of the spinal cord to the L5 head. The ChAT positive cells and DiI positive labeled cells overlap partially. Compared with the control group, the number of myenteric nerve fibers in the bladder reconstruction group was less and the staining density was also lighter (P <0.05). However, the density of nerve fibers in the reconstructive group was significantly increased compared with that in the spinal cord transection group (P < 0.05), and there was obvious redistribution of nerves. Conclusions After the artificial internal reflex arc was established, the new efferent branch was the somatic nerve, which could grow into the parasympathetic nerve fibers. The neurotransmitter was still acetylcholine, the regeneration of intracapsular cholinergic nerve fiber and the activity of acetylcholine Nerve redistribution occurs, which may play a role in bladder control urination.