兔膀胱出口梗阻模型的建立及多沙唑嗪对膀胱功能的影响

发布时间：2018-05-26 20:59

本文选题：膀胱出口梗阻 + 顺应性　；参考：《天津医科大学》2009年硕士论文

【摘要】：目的：通过建立兔膀胱出口梗阻的动物模型,观察梗阻后膀胱壁组织结构和膀胱顺应性的变化,研究其病理生理发展变化的机制和关键环节。探讨多沙唑嗪(doxazosin)对梗阻后膀胱形态和膀胱功能的影响,以期可以找到合适的干预点来解除或缓解膀胱出口梗阻后膀胱壁纤维化和膀胱的低顺应性。方法： 36只雄性新西兰兔随机分成4组：A组9只为对照组,B组9只为梗阻组,C组9只为梗阻加用多沙唑嗪组,D组9只为对照加用多沙唑嗪组。B组和C组均手术建立膀胱出口部分梗阻模型,方法相同。对照组只做游离,不结扎。手术后5周对4组进行尿动力学检测,检测完成后留取膀胱标本,常规HE染色观察膀胱出口梗阻后膀胱壁形态学变化。结果： 5周后膀胱出现了典型的梗阻表现：梗阻组及梗阻后应用多沙唑嗪组的膀胱重量分别为(16.9±4.4)g和(8.9±5.9)g,均明显重于对照组的(2.7±0.5)g,P0.01。梗阻后应用多沙唑嗪组与梗阻组相比,膀胱重量明显减轻,P0.01。梗阻组膀胱容量为(64.0±24.5)ml,明显大于对照组(29.3±10.4)ml,P0.01,梗阻后服用多沙唑嗪组膀胱容量为(42.2±19.0)ml,与梗阻组相比减小,P0.05。梗阻组膀胱漏尿点压为(29.3±11.5)cmH2O,明显高于对照组(16.5±3.6)cmH2O,P0.01,梗阻后服用可多华组(15.2±2.8)cmH2O,与梗阻组相比明显减低,P0.01。梗阻组与对照组膀胱顺应性分别为(5.53±4.41)和(2.46±1.03)ml/cmH2O,差异有统计学意义(P0.05)。光镜观察到兔膀胱出口梗阻后,平滑肌增生肥大,肌束间胶原纤维浸润显著增多,梗阻后加用多沙唑嗪可以减轻膀胱壁增厚程度。结论： (1)通过兔膀胱颈不全结扎法建立的BOO实验动物模型具有方法简便、存活率高、稳定性好等特点,适用于膀胱出口梗阻的相关实验研究。 (2)膀胱出口梗阻5周后膀胱结构和功能发生了改变：膀胱重量显著增加,膀胱容量明显增加；光镜观察到逼尿肌肥大,肌束间胶原纤维浸润显著增多。 (3)多沙唑嗪可使降低膀胱出口梗阻后膀胱重量和容量的增加程度,改善梗阻后膀胱壁平滑肌血供,降低膀胱漏尿点压,保护膀胱功能,延缓膀胱出口梗阻后膀胱失代偿的进展。
[Abstract]:Objective: By establishing an animal model of bladder outlet obstruction in rabbits, the changes of bladder wall structure and bladder compliance after obstruction were observed, and the mechanism and key links of its pathophysiological development were studied. To investigate the effect of doxazosin on bladder morphology and bladder function after obstruction, we hope to find a suitable intervention point to relieve or relieve bladder wall fibrosis and bladder low compliance after bladder outlet obstruction. Methods: 36 male New Zealand rabbits were randomly divided into 4 groups: control group (n = 9), obstruction group (n = 9), doxazosin group (n = 9), control group (n = 9), doxazosin group (n = 9) and group C (n = 9). Outlet partial obstruction model, The method is the same. In the control group, only free, no ligation. Five weeks after operation, the urodynamics of the four groups were examined, and the bladder specimens were collected after the detection. The morphological changes of bladder wall after bladder outlet obstruction were observed by routine HE staining. Results: After 5 weeks, typical bladder obstruction appeared: the weight of bladder in obstruction group and doxazosin group were 16.9 卤4.4 g and 8.9 卤5.9 g, respectively, which were significantly higher than that in control group (2.7 卤0.5g / g). The weight of bladder in doxazosin group was significantly lower than that in obstruction group (P 0.01). The bladder capacity in the obstruction group was 64.0 卤24.5ml, which was significantly higher than that in the control group (29.3 卤10.4ml). After obstruction, the bladder capacity of the group treated with doxazosin was 42.2 卤19.0ml, which was lower than that of the control group (P 0.05). The urinary leakage point pressure of the obstruction group was 29.3 卤11.5cm H _ 2O, which was significantly higher than that of the control group (16.5 卤3.6g 路h _ 2O) P 0.01. after the obstruction, the bladder leakage point pressure was 15.2 卤2.8 cm _ H _ 2O, which was significantly lower than that in the obstruction group. The bladder compliance was 5.53 卤4.41 in the obstruction group and 2.46 卤1.03ml / cm H _ 2O in the control group. The difference was statistically significant (P < 0.05). It was observed by light microscope that the smooth muscle proliferated and hypertrophy and the infiltration of collagen fibers between muscle bundles increased significantly after bladder outlet obstruction in rabbits. Adding doxazosin to the bladder wall after obstruction could reduce the thickness of bladder wall. Conclusion: 1) the BOO experimental animal model established by incomplete ligation of bladder neck in rabbits has the advantages of simple method, high survival rate and good stability, which is suitable for the experimental study of bladder outlet obstruction. 2) after 5 weeks of bladder outlet obstruction, the structure and function of bladder were changed: the weight of bladder increased significantly, the volume of bladder increased, and the detrusor hypertrophy and the infiltration of collagen fibers between muscle bundles were observed under light microscope. Doxazosin can reduce the increase of bladder weight and volume after bladder outlet obstruction, improve the blood supply of bladder wall smooth muscle, reduce bladder leakage point pressure, protect bladder function and delay the progress of bladder decompensation after bladder outlet obstruction.
【学位授予单位】：天津医科大学
【学位级别】：硕士
【学位授予年份】：2009
【分类号】：R-332;R694

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