北京生物醫(yī)學工程

低頻電刺激對脊髓損傷后膀胱過度活動抑制的仿真研究

Simulation Research on Inhibition Effect of Overactive Bladder After Spinal Cord Injury Using Low Frequency Electrical Stimulation

作者：董謙張旭陳國慶廖利民孫晨崔南

單位：首都醫(yī)科大學生物醫(yī)學工程學院（北京100069）

關鍵詞：神經(jīng)；仿真；低頻電刺激；刺激模式；膀胱過度活動癥

分類號：

出版年·卷·期（頁碼）：2011·30·1（10-14）

摘要：

目的探討低頻脈沖（0~10Hz）刺激時，不同刺激波形對脊髓損傷后逼尿肌反射亢進誘發(fā)的膀胱過度活動癥的結果，以尋求抑制膀胱過度活動的最優(yōu)刺激波形。方法首先根據(jù)McNeal的神經(jīng)纖維電纜模型，基于Frankenhaeuser-Huxley (FH) 方程建立有髓神經(jīng)纖維的膜外點電極刺激的仿真系統(tǒng)，評價低頻電刺激中的四種波形，即正向脈沖、負向脈沖、雙向對稱脈沖、雙向不對稱脈沖的效果。通過電刺激脊髓損傷犬的陰部神經(jīng)實驗，驗證仿真條件下最優(yōu)刺激波形的臨床效果。結果仿真實驗表明雙向不對稱脈沖的抑制效果最佳；動物實驗表明以3V、0.1ms的正向脈沖為起始脈沖，結合1V、0.3ms的負向脈沖的雙向不對稱波形的抑制效果為最優(yōu)。結論低頻脈沖刺激脊髓損傷犬陰部神經(jīng)時，正向脈沖在前的雙向不對稱脈沖的刺激波形仿真效果最佳，并適用于臨床實驗，能夠有效抑制膀胱過度活動，保護神經(jīng)避免電化學損傷。

Objective To investigate the effects of various stimulus waveforms in low frequency (0-10Hz) on the inhibition of overactive bladder, caused by detrusor hyperreflexia after spinal cord injury, and find a new stimulus waveform which can inhibit the bladder overactivity effectively.Methods According to the McNeal’s lumped circuit model theory of the myelinated axon, a simulation system based on the Frankenhaeuser-Huxley (FH) equations was built at first, to study the nerve fiber’s responses of several stimulus waveforms. Four kinds of stimulus waveforms were anodal pulse, cathodal pulse, biphasic symmetrical pulse and biphasic asymmetrical pulse. The clinic performance of the best stimulus waveform from the simulation results was also validated by stimulating pudendal nerve of the male Beagle dogs, which were spinal cord injured. The simulation results demonstrated that biphasic asymmetrical pulse was the best stimulus patternin the low frequency stimulation.Results From the animal experiment, the results also showed that the anodal-leading, biphasic asymmetrical pulse, which is composed of anodal pulse in 3V, 0.1ms and cathodal pulse in 1V, 0.3ms, had the best stimulation effect.Conclusion For pudendal nerve electrical stimulation, the anodal-leading, biphasic asymmetrical stimulus pattern has thebest simulation result, and is possible to apply in the clinic, which can inhibit overactive bladder effectively, and protect the nerve fiber from electrochemiscal injury.

參考文獻：

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