【摘要】 目的探讨人膀胱出口梗阻(BOO)后逼尿肌酶学和形态学的变化及意义。方法采集8例无BOO膀胱肿瘤患者及8例伴BOO良性前列腺增生患者的膀胱逼尿肌肌条,分别对组织中丙二醛(MDA)含量和超氧化物歧化酶(SOD)、一氧化氮合酶(NOS)、Ca2+Mg2+-ATP酶活性进行测定,并做电镜观察。结果对照组膀胱逼尿肌组织中SOD活性(20.39±2.02)U/mg蛋白、NOS活性(1.81±0.38)U/mg蛋白,Ca2+Mg2+-ATP酶活性(1.47±0.43)μmol P i/mg蛋白,BOO组则分别为(12.77±2.62)U/mg蛋白,(1.36±0.22)U/mg蛋白,(0.97±0.33)μmol P i/mg蛋白(P<0.05),BOO组MDA含量(1.70±0.22)nmol/mg蛋白低于BOO组(2.42±0.69)nmol/mg蛋白(P<0.05)。电镜观察BOO组逼尿肌细胞中粗面内质网明显扩张、脱颗粒,线粒体水肿明显、空泡变性和线粒体内嵴减少、消失,有的细胞内可见大量溶酶体。结论人BOO后缺血再灌注参与人逼尿肌功能失代偿的演化过程,减少自由基产生和避免过度超氧化反应仍是防止或减缓BOO后膀胱逼尿肌发生一系列病理变化的关键。更多还原

【Abstract】 Objective To evaluate the significance of enzymologic and morphologic changes of the detrusor muscle after bladder outlet obstruction（BOO）.Methods The bladder detrusor muscles of 8 cases of BPH with BOO（BOO group） and another 8 cases of bladder tumor without BOO（control group） were collected.The content of MDA and the activity of SOD,NOS and Ca²⁺Mg²⁺-ATPase in both groups were measured,and observed under electron microscope.Results The activities of SOD（20.39±2.02）U/mg Protein,NOS（1.81±0.38）U/mg Protein,Ca²⁺Mg²⁺ATPase（1.47±0.43）μmol Pi/mg Protein of the detrusor muscles in control group were significantly higher than those of the detrusor muscles in BOO group（12.77±2.62）U/mg Protein,（1.36±0.22）U/mg Protein and（0.97±0.33）μmol Pi/mg Protein;P<（0.05）.The content of MDA of the detrusor muscles in control group（1.70±0.22）nmol/mg Protein was lower than that of the detrusor muscles in BOO group（2.42±0.69）nmol/mg Protein,P<0.05.Electron microscopy showed lots of abnormities in the detrusor muscles in BOO group.The dilatation and degranulation of rough endoplasmic reticulum were obvious.Dropsy and vacuole denaturalization were found in mitochondria.The mitochondrial crista decreased or disappeared.A plenty of lysosomes were also found in the detrusor muscle cells.Conclusions Ischemia-reperfusion following BOO is involved in the decompensation process of detrusor muscle function.Reducing the production of free radicals and avoiding excessive superoxidation are the keys to preventing or slowing down the process of pathologic changes of the detrusor muscles after BOO.更多还原