前列腺增生症的逼尿肌超微结构变化

Ultrastructural changes of detrusor musculature in bladder outlet obstruction due to BPH

为了研究前列腺增生症（ＢＰＨ）引起的膀胱逼尿肌超微结构变化，对１３例ＢＰＨ患者、９例同龄无膀胱颈梗阻（ＢＯＯ）老年人及８例正常青年人逼尿肌进行透射电镜观察。结果发现：ＢＰＨ的逼尿肌超微结构特点为：（１）平滑肌细胞（ＳＭＣ）肥大、扭曲变形，排列不齐；（２）ＳＭＣ之间的间隙明显增宽，内有大量胶原纤维，细胞间中间连接明显减少；（３）肌质膜内小泡小凹明显减少，细胞内肌丝萎缩，排列不齐，细胞器退变。认为ＢＰＨ超微结构变化的结果引起逼尿肌功能改变，从而加速ＢＰＨ的病理生理进程。

The ultrastructure of detrusor musculature was studied by means of transmission electron microscopy in 13 cases of bladder outlet obstruction due to BPH, 9 cases of aged male without obvious bladder outlet obstruction and in 8 normal young men. The changes of the detrusor musculature observed in bladder outlet obstruction due to BPH were as follows: (1) Enlarged hypertrophic muscle cells with distorted contour. (2) Wide separation between muscle cells with reduction of intermediate cell junction and with abuandant collagen fibrils and fibres between individual cells. (3) Reduction of caveali and myofilaments and degeneration of cellular organelles. These structural changes would impair the contractibility of the detrusor and hence would accelerate the pathophysiologic changes in BPH.