注射人脐带间充质干细胞到耻尾肌及膀胱颈对压力性尿失禁的疗效比较

Therapeutic effect of hUCMSC injection into pubococcygeus and bladder neck on the recovery of SUI

关键词:  人脐带间充质干细胞  压力性尿失禁  耻尾肌  膀胱颈

Key words:  human umbilical cord mesenchymal stem cell  stress urinary incontinence  the pubococcygeus  bladder neck

摘要:

目的　探讨移植人脐带间充质干细胞（hUCMSC）到耻尾肌及膀胱颈对雌鼠压力性尿失禁（SUI）治疗的有效性。方法　40只大鼠分为正常对照组8只和造模大鼠（采用切除双侧卵巢后气囊压迫牵拉阴道壁的方法造模）32只。后者均分为治疗A组、治疗B组：耻尾肌、膀胱颈注射hUCMSC；对照A组、对照B组：耻尾肌、膀胱颈注射生理盐水。注射前、注射后1个月检测最大膀胱容积（MCC）、漏尿点压力（LPP）及进行“指压实验”。结果　与正常对照组相比，造模大鼠LPP均低，指压实验阳性率均高，差异有统计学意义（P<0.05）。移植前后治疗A组与对照A组比较：MCC差异无统计学意义（P>0.05）；治疗A组LPP变化不大，对照A组LPP下降，差异有显著统计学意义（P<0.01）。与对照B组比较：治疗B组MCC增加较多，差异有统计学意义（P<0.05）；LPP升高更明显，差异有显著统计学意义（P<0.01）。结论　通过模拟产伤及绝经能获得稳定的SUI动物模型。耻尾肌注射hUCMSC可以提高SUI大鼠的尿道闭合压，但不能改善储尿能力。膀胱颈注射hUCMSC可提高SUI大鼠尿道闭合压的同时改善储尿能力。

Abstract:

Objective To investigate the effectiveness of human umbilical cord mesenchymal stem cells (hUCMSCs) injection into the pubococcygeus and bladder neck in the treatment of female stress urinary incontinence (SUI) in rats. Methods Forty female rats were divided into normal control group (n=8) and model groups (n=32). The rat model was established by balloon dilation and traction of the vagina after bilateral ovariectomy. The model groups were further divided into treatment groups A and B (injection of hUCMSC into the pubococcygeus and bladder neck, respectively) and control groups A and B (injection of normal saline into pubococcygeus and bladder neck, respectively). Before injection and one month after injection, all the rats received “finger pressure test” and urodynamic measurements of maximum bladder capacity (MCC) and leak point pressure (LPP). Results Compared with the normal control group, the rats in the model groups had lower LPP and higher positive rate of finger-pressing test, and the differences were statistically significant (P<0.05). In comparison of treatment group A and control group A, MCC did not change significantly before and after injection (P>0.05); LPP remained stable in treatment group A but decreased in control group A (P<0.01). Compared with control group B, MCC increased one month after injection in treatment group B (P<0.05). LPP increased in treatment group B but decreased in control group B (P<0.01). Conclusion The stable animal model of SUI can be obtained by simulating birth injury and menopause. HUCMSC injection into pubococcygeus could increase urethral closure pressure in SUI rats, but could not improve the ability of urine storage. HUCMSC injection into bladder neck could improve urinary storage capacity while increasing urethral closure pressure in SUI rats.