Objective To study the urodynamics , detrusor excitability change and Connexin43( Cx43 ) expression in neurogenic bladder caused by spinal cord injury at different levels. Methods Fifty - two SD female rats were randouly divide into 3 groups: healthy group, sacral spinal cord injured group ( DH ) and under below spinal cord injured group ( DA ); Transection of spinal cord was applied create neurogenic bladder model for each group; Four weeks later,conduct urodynamic study and detrusor muscle excitability were exmined and detection, and measure the Cx43 expression was detected by immunohistochemisty and Western blotting. Results DH Group detrusor leak point pressure was significantly higher than that of contral group, and DA Group. The detrusor leak point pressure in DA Group was significantly lower than that of the control group; The spontaneous detrusor muscle contraction frequency in DA group was significantly than that of control Group spontaneous detrusor muscle contraction frequency DA Group was significantly lower than that of the control group. Conclusion Urodynamic study is very useful for the early diagnosia and individualized treatment of the neurogenic bladder after spinal cord injury. The sacral cord injury was detrusor overactivity and the below - sacral spinal cord injury has detrusor weakness. The detrusor hyperreflexia and the increased detrusor contraction frequency are associated with amplitude of bladder detrusor. Increased Cx43 expression may be one of the mechanisms of detrusor hyperreflexia.%目的 探讨大鼠不同平面脊髓损伤(SCI)造成神经源性膀胱后尿动力学,逼尿肌兴奋性改变和Connexin43(Cx43)的表达情况.方法 成年健康SD雌性大鼠52只,将其随机分为对照组、骶上脊髓损伤(DH)组、骶下脊髓损伤(DA)组.采用脊横断法制备大鼠神经源性膀胱模型.4周后行尿流动力学检查,膀胱离体逼尿肌肌条兴奋性检测,免疫组化法和Western blotting检测Cx43表达情况.结果 DH组逼尿肌漏尿点压较对照组、DA组明显升高,DA组逼尿肌漏尿点压较对照组显著降低;DH组膀胱逼尿肌肌条自发性收缩的频率较对照组、DH组明显增高,DA组膀胱逼尿肌肌条自发性收缩的频率较对照组明显降低.DH组Cx43表达较对照组、DA组明显升高,DA组Cx43表达较对照组明显降低.结论 尿流动力学检查为神经源性膀胱的早期诊断及选择个体化治疗方案提供了一种有效的检查手段.DH组为逼尿肌反射亢进,DA组为逼尿肌反射无力,逼尿肌反射亢进与逼尿肌收缩频率与幅度增高有关,膀胱逼尿肌Cx43表达增高可能是逼尿肌反射亢进机制之一.
展开▼
