本文選題：壓力性尿失禁 + 腦源性神經營養(yǎng)因子�。� 參考：《山西醫(yī)科大學》2014年碩士論文

【摘要】：目的：探討陰部神經（PN）損傷后局部注入腦源性神經營養(yǎng)因子（BDNF）對壓力性尿失禁模型大鼠漏尿點壓力（LPP）及尿道外括約�。‥US）內腦源性神經營養(yǎng)因子表達的影響。 方法：SD大鼠進行模擬產傷（陰道氣囊反復擴張）和雙側卵巢切除手術建立壓力性尿失禁模型。2周后進行漏尿點壓力及噴嚏實驗評估模型建立是否成功。造模成功后的大鼠隨機分為3組：BDNF組，分離并損傷陰部神經后于損傷神經周圍局部注入腦源性神經營養(yǎng)因子，縫合后標記部位，，第4、6、8天分別于標記部位再次進行等量注射；生理鹽水組，分離并損傷陰部神經后于損傷神經周圍局部注入生理鹽水（注射量及注射方式同腦源性神經營養(yǎng)因子注射），第4、6、8天注射量、注射方法同上；假損傷組，同以上兩組分離陰部神經，但未損傷陰部神經，且縫合后未進行注射處理。2周后再次進行漏尿點壓力及噴嚏實驗測試，觀察漏尿點壓力變化。隨后處死大鼠，取大鼠尿道組織行HE染色觀察尿道組織變化。取尿道外括約肌行免疫組化觀察三組腦源性神經營養(yǎng)因子的表達是否不同。 結果：漏尿點壓力及噴嚏實驗評估造模成功后的大鼠隨機分為3組：BDNF組、生理鹽水組、假損傷組；3組陰部神經損傷2周后，漏尿點壓力統(tǒng)計學分析顯示,生理鹽水組漏尿點壓力低于BDNF組和假損傷組(P＜0.05)，差異有統(tǒng)計學意義；BDNF組與假損傷組漏尿點壓力相比，差異無統(tǒng)計學意義（P＞0.05）；HE染色結果顯示，生理鹽水組與假損傷組相比尿道全層變薄,結構不明顯,肌層萎縮,肌纖維斷裂及橫紋肌致密程度明顯下降，肌纖維也有一定程度萎縮。BDNF組與假損傷組相比肌纖維疏松程度差異不顯著；免疫組化結果顯示，假損傷組括約肌內腦源性神經營養(yǎng)因子含量低，與BDNF組及生理鹽水組比較差異有統(tǒng)計學意義（p＜0.05），BDNF組與生理鹽水組括約肌內腦源性神經營養(yǎng)因子含量比較差異無統(tǒng)計學意義（P＞0.05）。 結論： 1、損傷陰部神經后大鼠漏尿點壓力比建立大鼠壓力性尿失禁成功后漏尿點壓力有所下降，提示陰部神經損傷可能與大鼠壓力性尿失禁的程度有關。 2、陰部神經損傷后其靶器官尿道外括約肌內腦源性神經營養(yǎng)因子含量增加，可能有利于陰部神經功能恢復。 3、局部注射腦源性神經營養(yǎng)因子可能通過改善陰部神經損傷后神經肌肉的功能，提高了SUI大鼠的儲尿能力。
[Abstract]:Objective: to investigate the effect of local injection of brain-derived neurotrophic factor (BDNF) after pudendal nerve injury on the expression of brain-derived neurotrophic factor (BDNF) in rats with stress urinary incontinence. The stress urinary incontinence model was established by simulated labor injury (repeated dilatation of vagina balloon) and bilateral ovariectomies. The leak point pressure and sneezing test were used to evaluate the success of the model. The rats were randomly divided into 3 groups: 1: BDNF group. Brain derived neurotrophic factor (BDNF) was injected locally around the injured nerve after separation and injury of the pudendal nerve. In the saline group, after the pudendal nerve was isolated and injured, normal saline was injected locally around the injured nerve (the amount of injection and the mode of injection were the same as the injection of brain-derived neurotrophic factor), the injection volume was the same as that in the 4th day of 6th day, the method of injection was the same as that in the sham injury group. The pudendal nerve was separated from the above two groups, but the pudendal nerve was not damaged, and the leak point pressure and sneezing test were performed again after the suture. Then the rats were killed and the urethral tissue was stained with HE. The expression of brain-derived neurotrophic factor (BDNF) was observed by immunohistochemistry in the external sphincter of urethra. Results: the rats were randomly divided into 3 groups: 1. After 2 weeks of pudendal nerve injury in sham injury group, the leakage point pressure in normal saline group was lower than that in BDNF group and false injury group (P < 0.05), the difference was statistically significant between BDNF group and false injury group. There was no significant difference (P > 0.05) in HE staining. The results showed that the whole urethral layer became thinner, the structure was not obvious, the muscular layer atrophy, the muscle fiber rupture and the density degree of striated muscle decreased significantly in the saline group compared with the sham injury group. The results of immunohistochemistry showed that the content of brain-derived neurotrophic factor (BDNF) in sphincter of sham injury group was lower than that in sham injury group, and there was no significant difference in muscle fiber looseness between BDNF group and sham injury group. There was no significant difference between BDNF group and BDNF group and normal saline group (P > 0.05). Conclusion: 1. The leakage point pressure after pudendal nerve injury in rats with BDNF was not significantly different from that in normal saline group and BDNF group (P > 0.05). Compared with the successful establishment of stress urinary incontinence in rats, the pressure of leakage point decreased, The results suggest that the pudendal nerve injury may be related to the degree of stress urinary incontinence in rats. 2. After pudendal nerve injury, the content of brain-derived neurotrophic factor in the external sphincter of the target organ is increased. 3Local injection of brain-derived neurotrophic factor may improve the neuromuscular function after pudendal nerve injury and improve the capacity of urine storage in SUI rats.
【學位授予單位】：山西醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R711.59

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