前列腺增生病人膀胱平滑肌肌动蛋白的变化与尿流动力学参数的关系

Change in actin of smooth muscles in obstructed urinary bladder and its effect on bladder compliance

目的探讨梗阻后膀胱平滑肌肌动蛋白(Actin)的改变及意义。方法 16例开放手术治疗的前列腺增生(BPH)和7例无膀胱出口、尿道梗阻病人膀胱壁和三角区平滑肌组织,用ABC法测定Actin的表达,评价它与膀胱顺应性等改变的关系。结果正常与梗阻逼尿肌的Actin表达之间有显著性差异(P=0.002)。本实验组膀胱的顺应性为31.10±15.23ml/cm H_2O,膀胱顺应性与IPSS、UDP、Actin呈负相关(r=-0.7048,-0.7077,-0.6462)。结论梗阻后膀胱的平滑肌肌动蛋白将增加,平滑肌肌动蛋白的增加是梗阻后膀胱的顺应性下降的因素之一。

Objective To investigate the changes in actin of smooth muscles in obstructed urinary bladder and their implication. Methods 16 cases of BPH undergoing opening surgery and 7 patients with urethra obstruction and without bladder outflow were included in this study. The actin expression of smooth muscles in normal detrusor, obstructed detrusor and obstructed bladder neck was determined immunohistochemically to evaluate its relation with bladder compliance. Results Expression of actin in the normal detrusor was 28.6% median positive, 37.5% strong positive and 62.5% median positive in the obstructed detrusor, with the difference being significant (P=0.002). The bladder compliance in the cases of BPH was 31.10±15.23 ml/cm H_2O with a significant negative correlation of bladder compliance with IPSS, pressure of urgent voiding sensation and actin (r=-0.7084, -0.7077, -0.6462, respectively). Conclusion The actin of smooth muscles in obstructed bladder was increased, which was one of the factors for the decrease in bladder compliance.