女性腺性膀胱炎膀胱平滑肌层α_(1D)-AR表达的研究

α_(1D)-Adrenergic Receptor in Vesical Smooth Muscle of Cystitis Glandularis in Female

【目的】研究α1D-肾上腺素能受体(α1D-Adrenergic receptor,α1D-AR)在女性腺性膀胱炎(cystitisglandularis,CG)患者膀胱三角区及逼尿肌中平滑肌细胞的表达情况;探讨α1D-AR在引起下尿路症状、膀胱过度活动症中的作用机制。【方法】采用免疫组织化学法检测32例女性腺性膀胱炎患者及9例正常女性膀胱逼尿肌及三角区肌层中α1D-AR的表达情况,并结合尿动力学进行分析。【结果】32例腺性膀胱炎患者膀胱逼尿肌及三角区肌层的α1D-AR表达阳性细胞数比正常对照组显著增加,两者具有正相关关系(P<0.0001);32例腺性膀胱炎患者中,尿动力学表现为不稳定膀胱的9例患者的逼尿肌及三角区肌层α1D-AR表达阳性细胞数均比非不稳定膀胱患者的表达显著增加(P<0.0001)。20例膀胱出口梗阻患者的逼尿肌及三角区肌层α1D-AR表达与非膀胱出口梗阻患者无明显差异(P>0.05)。【结论】女性腺性膀胱炎患者膀胱逼尿肌层、三角区肌层的α1D-AR表达存在正相关关系,提示CG可同时引起此两部位α1D-AR表达增加。α1D-AR表达增加可能是引起女性腺性膀胱炎逼尿肌压升高、不稳定膀胱等引起的下尿路症状的原因之一。

[ Objective ] To study the expression of α1D-adrenergic receptor in the vesical smooth muscle of female patients with cystitis glandularis, and explore the mechanism of action how α1D-adrenergic receptor evoked overactive bladder and low urinary tract symptoms. [Methods]Immunohistochemistry was applied to detect the expression of α1D-adrenergic receptor in the vesical smooth muscle of 32 patients with cystitis glandularis in female and the same site samples from 9 normal women were used as control group. The relationship between urodynamic changes and the expression of 0% -adrenergic receptor were analyzed. [Results]There was statistical significance of the expression of o%-adrenergic receptor in detrusor and triangular smooth muscle between the two groups （P〈 0.0001）. Among the 32 patients with cystitis glandularis, there was statistical significance of the expression of α1D- adrenergic receptor in detrusor and triangular smooth muscle between 9 patients with unstable bladder and the other patients. There was not statistical significance of the expression of 0% -adrenergic receptor in detrusor and triangular smooth muscle between 20 patients with bladder outlet obstruction and the other patients. [ Conclusion ] There was positive correlation of the expression of αID-adrenergic receptor between detrusor and triangular smooth muscle of the patients with CG, and this revealed that CG may cause the increase of the expression of α1D- adrenergic receptor in vesical smooth muscle. The increasing expression of α1D-adrenergic receptor＇ s may be one of the reasons of the low urinary tract symptoms which were evoked by accentuation of pressure of detrusor and unstable bladder.