PATHOPHYSIOLOGY OF IDIOPATHIC DETRUSOR INSTABILITY AND DETRUSOR HYPER-REFLEXIA - AN INVITRO STUDY OF HUMAN DETRUSOR MUSCLE
PATHOPHYSIOLOGY OF IDIOPATHIC DETRUSOR INSTABILITY AND DETRUSOR HYPER-REFLEXIA - AN INVITRO STUDY OF HUMAN DETRUSOR MUSCLE
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DOI：
10.1111/j.1464-410x.1987.tb05031.x
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发表时间：
1987-12-01
期刊：
影响因子：
--
通讯作者：
MUNDY, AR
中科院分区：
文献类型：
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作者：
KINDER, RB;MUNDY, AR
肌条尿动力学正常膀胱和膀胱表现出特发性逼尿肌不稳定或逼尿肌反射亢进进行了比较，在等长条件下，在器官浴。在器官浴中等长收缩条件下，比较了不稳定和反射亢进患者的自发性收缩。自发性收缩在不稳定和反射亢进的肌肉中更常见，并且具有更大的幅度、频率和基础张力。电场刺激引起的频率依赖性收缩，这在很大程度上取消了河豚毒素（TTX）和阿托品在所有三种肌肉类型。频率响应曲线的比较表明，一个显着更大的敏感性比不稳定和高反射肌肉低刺激频率。乙酰胆碱在所有肌肉类型中引起剂量相关的收缩反应。不稳定肌和反射亢进肌的剂量反应曲线与正常肌的剂量反应曲线无显著差异。结果表明，不自主的逼尿肌收缩的病理生理学是共同的特发性逼尿肌不稳定和逼尿肌反射亢进，这是一个内在的逼尿肌神经调节机制的障碍。
Muscle strips from urodynamically normal bladders and from bladders exhibiting idiopathic detrusor instability or detrusor hyper-reflexia were compared under isometric conditions in an organ bath. Spontaneous contractions developed more often in unstable and hyper-reflexic were compared under isometric conditions in an organ bath. Spontaneous contractions developed more often in unstable and hyper-reflexic muscle and were of greater amplitude, frequency and basal tension. Electrical field stimulation caused a frequency-dependent contraction which was largely abolished by both tetrodotoxin (TTX) and atropine in all three muscle types. Comparison of their frequency response curves demonstrated a significantly greater sensitivity than that of unstable and hyper-reflexic muscle to low stimulation frequencies. Acetylcholine caused a dose-related contractile response in all muscle types. There were no significant differences between the dose response curves of unstable and hyper-reflexic muscle, and those of normal muscle. The results suggest that the pathophysiology of the involuntary detrusor contraction is common to both idiopathic detrusor instability and detrusor hyper-reflexia and that this is related to a disorder of an intrinsic neuromodulatory mechanism within the detrusor muscle.