局部注射BDNF对压力性尿失禁模型大鼠LPP及尿道外括约肌内BDNF的影响

发布时间：2018-06-08 03:15

本文选题：压力性尿失禁 + 脑源性神经营养因子　；参考：《山西医科大学》2014年硕士论文

【摘要】：目的：探讨阴部神经（PN）损伤后局部注入脑源性神经营养因子（BDNF）对压力性尿失禁模型大鼠漏尿点压力（LPP）及尿道外括约肌（EUS）内脑源性神经营养因子表达的影响。方法：SD大鼠进行模拟产伤（阴道气囊反复扩张）和双侧卵巢切除手术建立压力性尿失禁模型。2周后进行漏尿点压力及喷嚏实验评估模型建立是否成功。造模成功后的大鼠随机分为3组：BDNF组，分离并损伤阴部神经后于损伤神经周围局部注入脑源性神经营养因子，缝合后标记部位，，第4、6、8天分别于标记部位再次进行等量注射；生理盐水组，分离并损伤阴部神经后于损伤神经周围局部注入生理盐水（注射量及注射方式同脑源性神经营养因子注射），第4、6、8天注射量、注射方法同上；假损伤组，同以上两组分离阴部神经，但未损伤阴部神经，且缝合后未进行注射处理。2周后再次进行漏尿点压力及喷嚏实验测试，观察漏尿点压力变化。随后处死大鼠，取大鼠尿道组织行HE染色观察尿道组织变化。取尿道外括约肌行免疫组化观察三组脑源性神经营养因子的表达是否不同。结果：漏尿点压力及喷嚏实验评估造模成功后的大鼠随机分为3组：BDNF组、生理盐水组、假损伤组；3组阴部神经损伤2周后，漏尿点压力统计学分析显示,生理盐水组漏尿点压力低于BDNF组和假损伤组(P＜0.05)，差异有统计学意义；BDNF组与假损伤组漏尿点压力相比，差异无统计学意义（P＞0.05）；HE染色结果显示，生理盐水组与假损伤组相比尿道全层变薄,结构不明显,肌层萎缩,肌纤维断裂及横纹肌致密程度明显下降，肌纤维也有一定程度萎缩。BDNF组与假损伤组相比肌纤维疏松程度差异不显著；免疫组化结果显示，假损伤组括约肌内脑源性神经营养因子含量低，与BDNF组及生理盐水组比较差异有统计学意义（p＜0.05），BDNF组与生理盐水组括约肌内脑源性神经营养因子含量比较差异无统计学意义（P＞0.05）。结论： 1、损伤阴部神经后大鼠漏尿点压力比建立大鼠压力性尿失禁成功后漏尿点压力有所下降，提示阴部神经损伤可能与大鼠压力性尿失禁的程度有关。 2、阴部神经损伤后其靶器官尿道外括约肌内脑源性神经营养因子含量增加，可能有利于阴部神经功能恢复。 3、局部注射脑源性神经营养因子可能通过改善阴部神经损伤后神经肌肉的功能，提高了SUI大鼠的储尿能力。
[Abstract]:Objective: to investigate the effect of local injection of brain-derived neurotrophic factor (BDNF) after pudendal nerve injury on the expression of brain-derived neurotrophic factor (BDNF) in rats with stress urinary incontinence. The stress urinary incontinence model was established by simulated labor injury (repeated dilatation of vagina balloon) and bilateral ovariectomies. The leak point pressure and sneezing test were used to evaluate the success of the model. The rats were randomly divided into 3 groups: 1: BDNF group. Brain derived neurotrophic factor (BDNF) was injected locally around the injured nerve after separation and injury of the pudendal nerve. In the saline group, after the pudendal nerve was isolated and injured, normal saline was injected locally around the injured nerve (the amount of injection and the mode of injection were the same as the injection of brain-derived neurotrophic factor), the injection volume was the same as that in the 4th day of 6th day, the method of injection was the same as that in the sham injury group. The pudendal nerve was separated from the above two groups, but the pudendal nerve was not damaged, and the leak point pressure and sneezing test were performed again after the suture. Then the rats were killed and the urethral tissue was stained with HE. The expression of brain-derived neurotrophic factor (BDNF) was observed by immunohistochemistry in the external sphincter of urethra. Results: the rats were randomly divided into 3 groups: 1. After 2 weeks of pudendal nerve injury in sham injury group, the leakage point pressure in normal saline group was lower than that in BDNF group and false injury group (P < 0.05), the difference was statistically significant between BDNF group and false injury group. There was no significant difference (P > 0.05) in HE staining. The results showed that the whole urethral layer became thinner, the structure was not obvious, the muscular layer atrophy, the muscle fiber rupture and the density degree of striated muscle decreased significantly in the saline group compared with the sham injury group. The results of immunohistochemistry showed that the content of brain-derived neurotrophic factor (BDNF) in sphincter of sham injury group was lower than that in sham injury group, and there was no significant difference in muscle fiber looseness between BDNF group and sham injury group. There was no significant difference between BDNF group and BDNF group and normal saline group (P > 0.05). Conclusion: 1. The leakage point pressure after pudendal nerve injury in rats with BDNF was not significantly different from that in normal saline group and BDNF group (P > 0.05). Compared with the successful establishment of stress urinary incontinence in rats, the pressure of leakage point decreased, The results suggest that the pudendal nerve injury may be related to the degree of stress urinary incontinence in rats. 2. After pudendal nerve injury, the content of brain-derived neurotrophic factor in the external sphincter of the target organ is increased. 3Local injection of brain-derived neurotrophic factor may improve the neuromuscular function after pudendal nerve injury and improve the capacity of urine storage in SUI rats.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R711.59

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