雄性大鼠膀胱出口梗阻两种模型制作方法的比较研究

目的 通过采用耻骨后膀胱颈和会阴途径球部尿道部分结扎两种方法,建立雄性大鼠膀胱出口部分梗阻（paritial bladder outlet obstraction,pBOO）模型,并对所建模型进行鉴定和比较,为pBOO后膀胱重构（bladder reconstruction）的深入研究提供一种成活率高,复制性和稳定性较好的动物模型.方法 80只健康雄性Wistar大鼠随机分为三组：I组为假手术组（对照组）,20只;II组为耻骨后途径膀胱颈部分结扎组,30只;III组为会阴途径球部尿道部分结扎组,30只.依据梗阻时间分别将I组、II组、III组大鼠随机分为2周组和4周组,于术后2周和4周对大鼠行尿动力学检测后,完整切除膀胱测其重量,将精囊腺组织和部分膀胱用4%甲醛固定,HE染色观察组织学变化.结果 II组和III组成活率分别为73.3%和80.0%,二者无统计学意义;I组、II组、III组建模手术时间分别为（9.75±2.29）、（17.33±3.54）、（10.77±2.44）min,II组与I组和III组比较差异均有统计学意义;I组、II组、III组的2周组和4周组逼尿肌漏尿点压（detrusor leak point pressure,DLPP）分别为（26.31±2.32）、（27.34±3.93）、（24.68±2.39）mmHg和（26..42±2.41）、（34.23±3.01）、（32.63±3.20）mmHg,I组与II组和III组的4周组比较差异有统计学意义,II组和III组的2周组和4周组比较差异均有统计学意义.结论 耻骨后途经膀胱颈部分结扎和会阴途径球部尿道部分结扎两种方法都能成功建立雄性大鼠pBOO模型,与耻骨后途径相比,会阴途径成活率高,手术操作时间短,复制性和稳定性好.

Comparison of two methods to establish male rat model of partial bladder outlet obstruction

Objectives To compare the retropubic and perineal approaches in establishing partial bladder outlet obstruction in male rats, and provide an effective and reliable method to prepare the rat model to serve researches on mechanism of bladder reconstruction. Methods Eighty healthy male Wistar rats were used in this study, and randomly divided into three groups. Group I ： Twenty rats were used for sham operation with a perineal incision. Group II ： Thirty rats were chosen for midprostatic obstruction using a retropubic approach. Group III： Thirty rats were used for bulbous urethral obstruction through a perineal incision. The groups II and III were further randomly divided into 2-week and 4-week subgroups. After 2 and 4 weeks, respectively, all experimental rats were anesthetized and underwent cystometric evaluation. Then the rats were sacrificed, and the organs including bladder and seminal vesicle were removed. The bladder body was weighted and recorded, and then a portion of the bladder body and the seminal vesicle were fixed in 4% paraformaldehyde solution. Remaining bladder tissue was saved in the liquid nitrogen. Results The survival rate of group II and III was 73.3% and 80.0% , respectively （P 〉0.05）. The operation time in the three groups was （9.75 ±2.29） , （ 17.33 ± 3.54） and （ 10.77 ± 2.44） min, respectively. The operation times of groups I and III were significantly shorter than that of the group II （P 〉 0. 05 ）. DLPP of the group 1-and 2-week and 4-week subgroups of Groups II and III were （26.31 ±2.32）, （27.34±3.93）, （24.68 ± 2. 39 ） mmHg and （26.42 ±2.41）, （34.23 ±3.01）, （32.63±3.20） mmHg, respectively, showing a significant difference between the group I and the 4-week sbugroups of Group II and III, and between the 2-week and 4-week subgroups of groups II and III （P 〈0. 05）. Conclusions Both the retropubic and perineal approaches can be used to successfully establish a partial bladder outlet obstruction in male rats. Compared with the retropubic approach, the perineal approach has advantages such as shorter operation time, a higher survival rate, better reproducibility and stability of the animal models, and that this rat model better resembles the progress of human male partial bladder outlet obstruction.