摘要
目的 研究糖尿病膀胱病变 (Diabeticcystopathy ,DCP)储尿期尿动力学特征及膀胱感觉功能障碍 ,为阐明DCP的发病机制提供实验依据。方法 分别以链脲佐菌素 (STZ)、蔗糖诱导制作大鼠DCP模型及利尿模型 ,正常大鼠作对照。采用免疫组化结合图像分析技术观察膀胱感觉神经递质CGRP及其纤维改变 ;制备离体全膀胱 ,作膀胱灌注测压观察膀胱顺应性改变 ;放免法测定逼尿肌舒张信号转导分子cAMP。结果 DCP8周时 ,膀胱壁尤其是粘膜下层的CGRP及其神经纤维明显减少 ;离体膀胱测压显示糖尿病膀胱顺应性升高 ;膀胱舒张作用明显弱于对照组和利尿组 ,逼尿肌cAMP含量显著低于后者。结论 ①DCP对膀胱功能的损害是多方面的 :CGRP为主要递质的粘膜下层膀胱容量感觉纤维明显减少 ,膀胱顺应性改变是DCP的致病机制之一。②DCP早期即已发生储尿期功能障碍 ,并且可能是膀胱收缩功能损伤的因素。③非糖尿病性利尿状态 (多尿 )对膀胱功能构成一定的损害作用 ,但不是DCP形成的主要原因。提示临床上对糖尿病患者作必要的尿动力学检查能较早发现DCP 。
Objective To provide experimental basis for further study of the mechanism of urinary storage dysfunction of diabetic cystopathy (DCP). Methods Steptozotocin(STZ) induced and sucrose induced diabetic rats were employed as DCP and diuresis models. Normal rats served as the control. The changes of calcitonin gene related peptide(CGRP) were analyzed by immunocytochemical method and computer assisted image analysis software. Compliance of the whole bladder prepared in vitro was evaluated by bladder irrigation. The messenger molecule cAMP of detrusor relaxation was determined by radioimmunological assay. Results Compared with those in other groups, the CGRP immunoreactive positive nerve fibers and content of this neurotransmitter significantly decreased in the bladder wall, especially in the submucosa. Significantly higher bladder compliance was observed( P <0 01). The cAMP of diabetic bladder was significantly lower than that in sucrose diuresis and control groups, which was (0 37±0 04) Pmol, (0 69±0 09) Pmol and (0 74±0 07)Pmol. Conclusion Multiple factors may be involved in DCP. The bladder compliance is important in urinary storage dysfunction of diabetic bladder which appears in the early stage of DCP and may also be harmful for bladder contraction. Non diabetic diuresis does not play a major role in the development of DCP. Therefore, urodynamic test as early as possible can help to diagnose DCP in diabetic patients.
出处
《第三军医大学学报》
CAS
CSCD
北大核心
2003年第22期1999-2001,共3页
Journal of Third Military Medical University
基金
重庆市科委应用基础基金课题 ( 1998)~~
关键词
糖尿病膀胱病变
膀胱顺应性
舒张
diabetic cystopathy
bladder compliance
relaxation
