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目的 探讨脊髓发育不良性膀胱的病理变化与尿流动力学分型之间的关系以及临床意义。方法 采用免疫组化和Masson三色法观察 38例脊髓发育不良性膀胱 (MB)及 11例正常膀胱组织标本中平滑肌与结缔组织之间的结构变化。结果 ①MB组和正常组对α 平滑肌肌动蛋白均表达 ,而对α 横纹肌肌动蛋白均不表达 ;②MB组的结缔组织含量逼尿肌反射低下组 (0 .2 2 3± 0 .0 97) ,逼尿肌反射亢进组 (0 .5 4± 0 .11)均明显高于正常组 (0 .13± 0 .0 8) (P <0 .0 1) ,而逼尿肌反射亢进组与反射低下 /无反射组之间差异亦有显著性意义 (P <0 .0 5 ) ;③逼尿肌反射亢进组中有 17例(6 8.0 % )可见平滑肌细胞核排列紊乱 ,而反射低下 /无反射组肌束明显细小。结论 MB的病理改变与尿流动力学结果密切相关 ,临床上应采用相应的手术方法进行处理
Objective To investigate the relationship between the pathological changes of urinary bladder dysplasia and urodynamic classification and its clinical significance. Methods Immunohistochemistry and Masson’s trichrome were used to observe the structural changes between smooth muscle and connective tissue in 38 cases of dysplastic spinal cord (MB) and 11 cases of normal bladder tissue. Results ① The expressions of α-smooth muscle actin and the α-striate muscle actin were not expressed in both the normal group and the normal group. ② The connective tissue content of the group DM was lower than that of the normal group (0.22 ± 0.907) , Detrusor hyperreflexia group (0.54 ± 0.11) were significantly higher than the normal group (0 .13 ± 0. 0 8) (P <0 01), and detrusor hyperreflexia group and There was also a significant difference between the groups with low reflex / no reflexes (P <0.05); ③ In 17 cases with detrusor hyperreflexia (17.6%), the smooth muscle cells were disordered while the reflex / Reflex group muscle bundle was obviously small. Conclusion The pathological changes of MB are closely related to the results of urodynamics, and should be treated by appropriate surgical methods