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On the Studies of Detrusor-Sphincter Synergia of Wistar Rats via Karhunen-Loève Expansion

利用Karhunen-Loève展開式對大白鼠逼尿肌與外尿道括約肌共濟協調之研究

摘要


過去的生理學家認為膀胱在儲尿階段時,外尿道括約肌(external urethral sphincter)是有活動的,而膀胱是靜止的;而在排尿時,膀胱有活動的,外尿道括約肌反而是是靜止的[1][2]。然而在我們的研究裡面,卻顯示正常大白老鼠在排尿時,膀胱與外尿道括約肌之間有共濟協調(synergia)的情形產生。而在上薦骨脊髓受傷(suprasacral spinal cord injured)的老鼠中卻產生膀胱與外尿道括約肌之間共濟失調的情形[5][6]。在本篇論文裡,我們利用Karhunen-Loève expansion (KLE)的方法來研究正常大白老鼠與上薦骨脊髓受傷大白老鼠的外尿道括約肌的肌電圖(electromyogram)和膀胱壓力圖(cystometrogram)。根據此分析方法可以顯示括約肌的肌電訊號與膀胱壓力訊號它們的本徵值(eigenvalue)及本徵模(eigenmode)在排尿的不同階段上是有差異的:正常老鼠在排尿階段,他們有較低數目的本徵模且膀胱迫尿肌與外尿道括約肌之間有較多的協調合作。儘管上薦骨脊髓受傷鼠在排尿階段的肌電圖也顯現了活躍的現象,但他們外尿道括約肌與膀胱迫尿肌的動力行為,根據我們的研究顯示是沒有秩序而且沒有互相協調合作。這種共濟失調(dyssynergia)的情形可以被認為是由於缺乏從脊髓而來的協調訊號所致。利用KLE方法作用在原始訊號和其協方差函數(covariance function)中的比例測試與誤差測試,可以提供我們正常大白鼠與脊髓受傷鼠在儲尿、排尿與復原時膀胱迫尿機與外尿道括約肌的動態量化資訊。KLE分析在搭配其他的參數使用後,將會對泌尿的機制有更深入的瞭解。

並列摘要


In normal Wistar rats, we have found that the voiding of the bladder has a synergic cooperation between the detrusor and the sphincter. On the contrary, the suprasacral spinal cord injured (SCI) rats usually exhibit dyssynergic contractions of the bladder and the external urethral sphincter (EUS). In this study, the cystometrograms (CMG) of the detrusor and the electromyograms (EMG) of the EUS of intact and SCI female Wistar rats are used to investigate the eigenmodes of synergic cooperation during micturition via Karhunen-Loève expansion (KLE). Here we show that the three different phases of urination of intact rats: initial, bursting and relaxation phase, have different number of eigenmodes. The SCI rats are also investigated with the KLE method. Results have indicated that our understanding of micturition mechanism of Wistar rats can be mightily improved.

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