感染性结石大鼠模型的尿路组织病理学改变-东南大学学报医学版

感染性结石大鼠模型的尿路组织病理学改变

单位：1. 南京医科大学附属江宁医院泌尿外科,江苏南京 211100;
2. 江苏省中医院泌尿外科,江苏南京 210029

分类号：R-33; R742.1

出版年·卷·期（页码）：2012·31·第一期（63-67）

摘要：

目的:通过构建感染性结石的大鼠模型,观察感染性结石的形成对尿路组织病理学的损害。方法:将SD雄性大鼠分为空白对照组(n=4)、假手术组(n=10)和实验组(n=10)。空白对照组膀胱内不置入任何异物。假手术组膀胱内不置异物,仅行膀胱无菌穿刺。实验组大鼠在腹腔麻醉后,于下腹部正中切开腹腔,提起膀胱,以无菌G18穿刺针穿刺膀胱,于膀胱顶部穿刺入膀胱,经穿刺针内腔,使用推杆将聚乙烯管(此前浸泡于10⁷CFU·ml^-1的奇异变形杆菌悬液中,置于恒温箱中共同培养8 h以上)推入膀胱,退出穿刺针后关闭腹腔。手术后第21天,将大鼠以过量麻醉方法全部处死,分离大鼠肾脏、输尿管和膀胱,并将获取的尿路组织标本置入4%多聚甲醛液中固定24 h,常规石蜡包埋尿路组织标本后进行相关的病理及免疫组化分析。结果:空白对照组与假手术组大鼠尿路组织病理学无明显变化,膀胱内无结石生成。实验组大鼠的尿路组织主要表现为肾输尿管膀胱的炎症改变;膀胱内有感染性结石的形成。结论:奇异变形杆菌及其解脲酶对尿路上皮细胞可以造成损伤,损伤后所产生的一系列病理生理改变以及细胞的适应性反应在感染性结石的形成中起了重要的作用。

Objective: To observe urothelial histopathological changes caused by infection stone formation in rat model. Methods: Adult male Sprague Dawley rats were divided into 3 groups: control group(n=4), sham operation group(n=10)and experimental group(n=10). There was no any operation in control group. In sham operated group the puncture needle(G18)with guideline was inserted into bladder without metal wire implanted into the bladder. In experimental group, the bladder was exposed through a short lower midline abdominal incision, the puncture needle(G18) with guideline was inserted aseptically into bladder, a polyethylene pipe, which had been contaminated by the Proteus mirabilis, was put into the puncture canal, then implanted into the bladder lumen through the guideline .The rats were sacrificed by excessive anesthesia at day 21 post challenge. The rats' kidney, ureter and bladder were removed aseptically, then placed in to 4% paraformaldehyde for 24 hours immediately. The tissues were paraffin-embedded, pathological and immunohistochemical analysis were taken. Results: No changes or stone formation in the rat kidney, ureter and bladde were found in control group and sham operation group. The histopathologic changes were mainly inflammatory changes for kidney, ureter and bladder in experimental group. Infection stones formation in bladder was found in experimental group. Conclusions: Proteus mirabilis and ureaplasma enzyme can damage urothelial epithelia cells and make a series of urothelial pathophysiological changes. These pathophysiological changes play an important role for formation of infection stones.

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