흰쥐의 방광출구 부분 폐색 후 방광근에 대한 알파 아드레날린 길항제의 반응
In Vitro Responses of Alpha-adrenergic Antagonist of Rat Detrusor Muscle after Partial Bladder Outlet Obstruction
손진희, 박흠례,
소속 상세정보
손진희 ( )
고려대학교 의과대학 비뇨기과학교실
박흠례 ( )
고려대학교 의과대학 비뇨기과학교실
KMID : 0358319990400040458
Abstract
서론
전립선비대증으로 인한 방광출구 부분 폐색은 폐색 그 자체에 의한 폐색증상과 방광 내에
요가 저장되는 동안 나타나는 배뇨근의 비정상 활동에 의한 자극증상으로 나눌 수 있다. 자
극증상에는 빈뇨, 야간빈뇨, 요급, 소량의 배뇨량 등이 있다. 이러한 자극증상이 나타나는 불
완전성 방광은 전립선비대증이 있는 환자의 약 50-75％에서 발생하는 것으로 알려져 있다.
불안정성 방광을 유발하는 원인은 뚜렷이 알려져 있지 않지만 방광의 베타 또는 알파수용체
의 밀도의 변화가 한가지 원인으로 보고되고 있다. 방광 배뇨근 내에 베타-아드레날린 수용
체 감소나 알파-아드레날린 수용체 증가가 방광출구폐색에 의한 이차적인 불안정성 방광을
유발할 수 있다. 불안정성 방광을 치료하는데 필요한 약제는 정상적인 배뇨 수축력을 유지
하면서 불안정성 방광수축을 조절하는 것이 바람직한데 전립선비대증 치료에 사용하는 알파
-아드레날린 길항제들은 방광출구폐색뿐만 아니라 방광 불안정성을 완화시킨다. 이에 저자
들은 방광출구의 부분 폐색으로 유발된 불안정성 방광에서 알파-아드레날린 길항제인
doxazosin, tamsulosin, prazosin등이 방광수축 억제효과를 나타내는지에 대하여 동물실험을
통하여 알아보고자 하였다. 한편, 방광출구폐색에 의한 방광의 부교감 및 교감신경수용체의
반응을 정상군과 비교하고자 하였다.
Purpose : Our experiments were done to determine the effects of alpha-1-adrenergic
antagonists which have been commonly used in the treatment of BPH against the
partially obstructed detrusor smooth muscle using in-vitro muscle strip study of female
rat bladder.
Materials and Methods : Partial obstruction was created by means of partial ligation
of the proximal urethra in 15 female Sprague-Dawley rats. After 6 weeks of obstruction,
1×0.5㎝ sized each bladder smooth muscle strip was stimulated by field stimulation(FS),
(1-32㎐) and bethanechol administration(10-7-10-7M). After
the control stimulations, each strip was pre-treated with doxazosin, tamsulosin, prazosin
and atropine for 30 minutes, and then same stimulations were repeated. Seperate strip
was pre-treated by propranolol for 30 minutes, and then was stimulated by
norepinephrine(10-4M) or phenylephrine(10-4M).
Results : After the administration of doxazosin, percent decreases of maximal tension
developed by FS was significantly greater in obstructed(26-50% of the control) than in
normal rats(0-12% of the control)(p<0.05). Field stimulated tension were inhibited more
in normal(32-40%) than in obstructed rats(p<0.05, 1-32㎐) after the administration of
prazosin. Atropine inhibited field stimulated tension to a greater degree in
normal(73-63%) than in obstructed(27-43%) rats (p<0.01, 1-32㎐). Complete inhibitory
effects of atropine against bethanechol
stimulation(10-7-10-4M) was achieved at
10-5M in normal rats. In obstructed rats, complete blockage was achieved
at 10-4M of bethanechol. Norepinephrine decreased basal tension both in
normal and obstructed rats. After pre-treatment of propranolol, phenylephrine and
norepinephrine did not show any increase of basal tension.
Conclusions : Our results suggest that changes of adrenoceptors may be the
underlying cause of bladder instability secondary to outflow obstruction as evidenced by
significant inhibition of the tension of the detrusor muscle by alpha-1-adrenoceptor
blocker(doxazosin but not by tamsulosin) onto in obstructed rat bladder. These results
also suggest that non-cholinergic components of bladder contraction are much more in
obstructed than in normal bladder. It also can be said that doxazosin may have
additional effects against bladder instability caused by BPH.
키워드
Partial bladder outlet obstruction; Alpha-adrenergic antagonist;
원문 및 링크아웃 정보
등재저널 정보