Microenergy acoustic pulse therapy restores function and structure of pelvic floor muscles after simulated birth injury.
Microenergy acoustic pulse therapy restores function and structure of pelvic floor muscles after simulated birth injury.
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DOI：
10.21037/tau-22-30
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发表时间：
2022-05
影响因子：
2
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微能声脉冲（MAP）治疗模拟产伤后骨盆底肌肉（PFM）结构和功能恢复的机制尚不清楚。将24只雌性Sprague-Dawley大鼠随机分为假手术对照组（sham）、阴道球囊扩张和卵巢切除术（VBDO）、VBDO + β-氨基丙腈（BAPN，一种不可逆LOX抑制剂）和VBDO + BAPN，并用MAP治疗（每组n=6）。MAP治疗2次/周，持续4周，洗脱1周，对所有24只大鼠进行功能和组织学研究。用生物力学方法研究了金属烤瓷修复体髂尾肌（IC）和耻尾肌（PC）的粘弹性。通过免疫荧光和Masson三色染色评估PFM的结构。泄漏点压力（LPP）测定表明，MAP治疗组的LPP高于VBDO和BAPN组。假手术组IC肌僵硬度（K）显著高于PC肌，而PC肌的盆底肌反跳活动（MRA）显著高于IC肌（分别为291.26±45.33和241.18±14.23 N/cm 2）。VBDO和BAPN均降低IC和PC的MRA，增加K。组织学检查显示VBDO和BAPN组的纤维组织（胶原）增加和肌纤维变性。MAP治疗显著降低胶原含量，改善肌纤维结构。在模拟产伤的动物模型中，MAP似乎通过再生肌肉纤维和改善生物力学性能来恢复PFM的结构和功能。
The mechanisms of the microenergy acoustic pulse (MAP) therapy on restoring structure and function of pelvic floor muscles (PFM) after simulated birth injury are not well understood. A total 24 female Sprague-Dawley rats were randomly grouped into sham control (sham), vaginal balloon dilation and ovariectomy (VBDO), VBDO + β-aminopropionitrile (BAPN, an irreversible LOX inhibitor), and VBDO + BAPN and treated with MAP (n=6 in each group). The MAP therapy was administered 2 times per week for 4 weeks with 1-week washout, the functional and histological studies were conducted in all 24 rats. The viscoelastic behavior of the PFM, including iliococcygeus (IC) and pubococcygeus (PC), was examined with a biomechanical assay. The structure of the PFM was assessed by immunofluorescence and Masson’s trichrome staining. The leak point pressure (LPP) assay demonstrated that the MAP therapy group had higher LPPs compared to that of VBDO and BAPN groups. In the sham group, the muscular stiffness (K) of IC muscle was significantly higher than that of PC muscle while the pelvic floor muscle rebound activity (MRA) of PC muscle was stronger than that of IC muscle (291.26±45.33 and 241.18±14.23 N/cm2, respectively). Both VBDO and BAPN decreased the MRA and increased the K in both IC and PC. Histologic examination revealed increased fibrous tissue (collagen) and degeneration of muscle fibers in both VBDO and BAPN groups. MAP therapy significantly reduced the collagen content and improved the architecture of muscle fibers. MAP appears to restore the structure and function of PFM by regenerating muscular fibers and improving biomechanical properties in an animal model of simulated birth injury.