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目的 探讨膀胱出口梗阻 (BOO)对逼尿肌兴奋性、收缩性、顺应性的影响及逼尿肌不稳定 (DI)的发病机理。 方法 建立Wistar大鼠BOO动物模型 ,6周后行充盈性膀胱测压及离体逼尿肌条机械牵拉、电及胆碱类药物刺激试验。 结果 BOO后DI的发生率为 6 9% ;逼尿肌顺应性升高 ;DI组与梗阻后稳定组及正常对照组相比 ,牵拉逼尿肌致其出现收缩时的张力明显降低 ,电刺激产生的收缩力明显减弱 ;DI组逼尿肌胆碱类药物刺激产生的收缩力较梗阻稳定组明显减弱。 结论 BOO后DI的发生率较高 ,不稳定逼尿肌的收缩功能受损较重 ,DI的发生与逼尿肌自身的肌源性改变密切相关。
Objective To investigate the effect of bladder outlet obstruction (BOO) on excitability, contractility and compliance of detrusor and the pathogenesis of detrusor instability (DI). Methods The animal model of BOO was established in Wistar rats. After 6 weeks, the rats were subjected to filling cystometry and mechanical detrusor in vitro detrusor strips, electrical and cholinergic stimulation tests. Results The incidence of DI after BOO was 69%, and the detrusor compliance was increased. Compared with the control group and normal control group, the tension of detrusor muscle in DI group was obviously decreased when contracting, Contractile force induced by stimulation was significantly weakened; contractile force produced by detrusor cholinergic stimulation in DI group was significantly weaker than that of stable group. Conclusions The incidence of DI is high after BOO, and the contractile function of unstable detrusor is severely impaired. The occurrence of DI is closely related to the myogenic changes of detrusor.