摘要
目的探讨神经源性逼尿肌过度活跃(NDOA)患儿逼尿肌超微结构改变及其与尿动力学参数的相关性。方法NDOA患儿18例(NDOA组),因上尿路疾病需要手术治疗而下尿路功能正常的患儿10例(对照组),均行尿动力学检查及逼尿肌组织活检。结果NDOA组的残余尿量、紧密细胞粘着数目和紧密细胞粘着与中间细胞连接比率均显著高于对照组,最大膀胱压测定容量(MCC),膀胱顺应性和中间细胞连接数目均显著低于对照组(P＜0．05)．若以紧密细胞粘着与中间细胞连接比率＞3为诊断NDOA的标准．则灵敏度为94%(17/ 18),特异度为100%(17/17)。MCC与紧密细胞粘着数目呈负相关(Beta=-0．638,P＜0．05),与中间细胞连接数目呈正相关(Beta=0．389．P＜0．05)。结论NDOA患儿的逼尿肌有特征性超微结构改变．且与其尿动力学参数有很好的相关性。
[Objective]To quantitatively evaluate ultrastructural changes of detrusor and the relation with urodynamic parameters of neurogenic detrusor overactivity(NDOA)in children.[Methods]According to the results of urodynamic examination,18 children with NDOA(NDOA group)and 10 children with upper urinary tract diseases but having normal lower urinary tract function(control group)were included in this study.Urodynamics examination and detrusor biopsies observed by transmission electron microscopy were performed in these two groups.[Results]The post void residual(PVR),close cell appositions(CCA,including protrusion junction and uhraclose abutments)per 500 cells and the ratio of CCA/intermediate cell junctions (ICJ)of NDOA group were significantly higher than those of control group,bladder compliance(BC),maximum cystometric capacity(MCC)and ICJ per 500 cells lower than those of control(P＜0.05).The sensitivity was 94% (17/18),and specificity was 100%(17/17)if the diagnsis standard of NDOA was the ratio of CCA/ICJ＞3.MCC had negative correlation with CCA(β=-0.638,P＜0.05)and positive correlation with ICJ(β=-0.389,P＜0.05).[Conclusions]There are distinct ultrastructural changes in the detrusor biopsies of the children with NDOA,and they can be used to predict urodynamic dysfunction.
出处
《山东医药》
CAS
北大核心
2007年第18期1-2,共2页
Shandong Medical Journal
基金
国家自然科学基金(30571931)
教育部新世纪优秀人才支持计划项目(2005ABB009)。
