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目的 观察大鼠脊髓圆锥损伤后大脑排尿功能区结构变化和Bcl-2的表达情况,探讨大脑排尿功能区退变的可能因素.方法 成年雌性SD大鼠36只,随机分为实验组(n=30)和对照组(n=6).实验组将大鼠L4以下脊神经切断制作脊髓圆锥损伤模型,对照组不作任何处理.实验组大鼠手术全部成功,术后3、5个月分别死亡1只大鼠,原因可能是肾功能衰竭及尿路感染.实验组于术后1d、1周以及1、3、6个月分别处死6、6、6、5、5只大鼠,对照组相同时间点各处死1只大鼠,取脑桥被盖背外侧部组织,行HE染色和Bcl-2免疫组织化学SP染色观察.结果 HE染色示,术后1d,实验组和对照组无明显区别,神经元细胞密集,排列整齐,核仁清楚;1周,实验组可见神经元细胞周围间隙稍增宽;1个月,实验组部分神经元出现细胞核固缩;3、6个月,实验组细胞核固缩的细胞越来越多,甚至部分细胞出现核消失.Bcl-2免疫组织化学SP染色示,对照组Bcl-2表达呈弱阳性.实验组术后1d即出现Bcl-2阳性表达,术后7 d Bcl-2阳性表达较对照组明显升高,并达高峰,术后1、3、6个月Bcl-2阳性表达逐渐下降,但仍高于对照组.结论 大鼠脊髓圆锥损伤后大脑排尿中枢出现组织退变、细胞坏死,Bcl-2表达升高可能与组织修复、大脑功能重塑有关.“,”Objective To observe the structural changes of urinary center and the expression of Bcl-2 after conus medullaris injury in rats brain so as to explore the possible influence factors of degeneration in brain.Methods Thirtysix adult Sprague-Dawley rats were randomly divided into experimental group (n=30) and control group (n=6).In the experimental group,the conus medullaris injury model was established by cutting off the spinal nerve below L4,and no treatment was done in the control group.The modeling operations in the experimental group were successful,and 2 rats died at 3 months and 5 months after modeling operation respectively,which may be caused by renal failure or urinary tract infection.In the experimental group,6,6,6,5,and 5 rats were killed at 1 day,1 week,and 1,3,6 months after operation respectively,and 1 rat was killed at each time point in the control group.The dorsolateral tissue of the pontine tegmentum was harvested to perform HE staining and Bcl-2 immunohistochemical SP staining.Results HE staining showed that there was no obvious difference between the experimental group and the control group at 1 day after operation,the neurons were densely packed,arranged neatly,and the nucleoli were clear;at 1 week,the space between the neurons in the experimental group were slightly widened;at 1 month,nucleus retraction in some neurons happened in the experimental group;at 3 and 6 months,the nuclei in the experimental group were more and more condensed,and even some cells disappeared.Bcl-2 immunohistochemical SP staining showed that the expression of Bcl-2 in the control group was weakly positive.The positive expression of Bcl-2 was found at 1 day after operation in the experimental group;the positive expression of Bcl-2 at 7 days after operation was significantly higher than that in the control group,and reached the peak;the positive expression of Bcl-2 decreased gradually at 1,3,and 6 months after modeling operation,but it was still higher than that of the control group.Conclusion The urinary center appears structure degeneration and necrocytosis after conus medullaris injury in rats brain.The elevated expression of Bcl-2 may be associated with brain tissue repair and function remodeling.