目的:观察电针对骶上脊髓损伤后神经源性膀胱大鼠尿流动力学、髓内细胞凋亡率及脊髓组织中Caspase-3表达的影响.方法:从60只雌性SD大鼠中随机抽取36只,按脊髓横断法制作神经源性膀胱模型后,将符合要求的模型大鼠24只随机分为模型组、电针组各12只,其余24只随机分为空白组、假手术组各12只;术后第19天取“次髎”“中极”“三阴交”“大椎”行电针干预,连续治疗7天后行尿流动力学检测,并用TUNEL法测定髓内细胞凋亡率、Western Blot法测定脊髓组织中Caspase-3蛋白的表达情况.结果:①尿流动力学,与空白组及假手术组比较:模型组、电针组的膀胱基础压力、膀胱最大压力、漏尿点压力升高(P＜0.05),膀胱最大容量及顺应性降低(P＜0.01);与模型组比较:电针组的膀胱基础压力、膀胱最大压力、漏尿点压力均降低(P＜ 0.05),膀胱最大容量及顺应性均升高(P＜0.01);②髓内细胞凋亡率,与空白组及假手术组比较:模型组及电针组的脊髓组织TUNEL阳性率明显升高(P＜0.01);与模型组比较:电针组的脊髓组织TUNEL阳性率明显降低(P＜0.01);③Caspase-3蛋白表达,与空白组及假手术组比较:模型组、电针组脊髓组织中Caspase-3蛋白表达明显升高(P＜0.01);与模型组比较:电针组脊髓组织中的Caspase-3蛋白表达下降(Jp＜0.05).结论:电针“次髂”“中极”“三阴交”“大椎”可改善骶上脊髓损伤后神经源性膀胱大鼠的膀胱压力、最大容量及顺应性,降低受损脊髓组织的凋亡率,其作用机制可能与脊髓组织中凋亡效应蛋白Caspase-3的表达下调有关.%Objective:To explore the effect of electroacupuncture (EA) on urodynamics,apoptosis rate and Caspase-3 in spinal tissue after completely supersacral spinal cord injury.Method:Among the total of 60 adult female Sprague-Dawley rats,36 were randomly selected for superspinal cord transection model,24 compliance model rats were randomly divided into model group and electroacupuncture group with 12 cases in each.Other rats randomly divided into control group,sham operation group with 12 cases in each.electroacupuncture group received electroacupuncture 7 days on "Ciliao Zhongji Sanyinjiao Dazhui" acupoints 19 days after model operation.Urodynamic test for bladder function,and the expression of Caspase-3 in the spinal cord was detected with Western blotting,apoptosis rate by TUNEL.Result:Compared with control group and sham operation group,bladder pressure,maximum bladder pressure,leak point pressure increased (P＜0.05),maximum bladder capacity and compliance decreased (P＜0.01) in the model group and electroacupuncture group,compared with the model group,bladder pressure,maximum bladder pressure,leak point pressure were decreased (P＜0.05),maximum bladder capacity and compliance increased (P＜0.01) in electroacupuncture group.Compared with control group and sham operation group,the positive rate of TUNEL in spinal cord tissue increased (P＜0.01) in the model group and electroacupuncture group decreased (P＜0.01) in electroacupuncture group.The expression of Caspase-3 was significantly higher in model group and electroacupuncture group than control group and sham operation group (P＜0.01),but the electroacupuncture group was significantly lower than model group (P ＜ 0.05).Conclusion:Electroacupuncture on "Ciliao Zhongji Sanyinjiao Dazhui" acupoints could improve the bladder pressure,maximum capacity and compliance of neurogenic bladder,and inhibit the rate of apoptosis in injured spinal cord tissue,the mechanism may be related to the inhibited expression of Caspase-3.
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