前列腺增生梗阻性逼尿肌不稳定对逼尿肌胆碱能神经的影响

The effect of detrusor instability secondary to benign prostatic hypertrophy on the density of acetylcholinesterasecontaining nerves

目的探讨前列腺增生（ＢＰＨ）梗阻性逼尿肌不稳定与乙酰胆碱能神经的关系。方法根据尿动力学，将研究对象分为ＢＰＨ梗阻逼尿肌稳定和梗阻逼尿肌不稳定组，并设无梗阻的膀胱肿瘤患者作为对照。取膀胱顶部逼尿肌作ＨＥ、Ｋａｒｎｏｖｓｋｙ－Ｒｏｏｔ直接法染色，乙酰胆碱脂酶（ＡｃｈＥ）结合镀银法染色、电镜观察和图像分析，通过形态测定检测了逼尿肌ＡｃｈＥ阳性神经密度。结果梗阻不稳定组和稳定组ＡｃｈＥ阳性神经密度较正常对照明显降低（Ｐ＜０．０１），且不稳定组ＡｃｈＥ阳性神经密度较稳定组也明显减低（Ｐ＜０．０５）。结论ＢＰＨ梗阻性逼尿肌不稳定与逼尿肌胆碱能神经密度降低（去神经）程度有关。

Objective To study the effect of detrusor instability secondary to benign prostatic hypertrophy (BPH) on the density of cholinesterasecontaining nerve in detrusor samples. Method Our present study included 3 groups confirmed by urodynamic evaluation. They were control group( 8 cases) , obstructive detrusor stability group (7), and obstructive instability group (12). The specimens were obtained from the dome of bladder. The AchEcontaining nerves were demonstrated by the method of KarnovskyRoots staining and AchE silver staining. The density of AchE containing detrusor nerves in specimens was examined with sterologic techniques. Result The density of AchEcontaining nerves in the obstructive detrusor instability group and the stability group was significantly decreased as compared with the control group(P<001). The density of AchE positive nerves were also significantly decreased in the obstructive instability group as compared with the obstructive stability group (P<005). Conclusion Detrusor instability secondary to BPH obstruction is related to the decrease of cholinergic innervation density in the detrusor muscles. 