单核细胞趋化因子-1在间质性膀胱炎中表达的研究

Expression of monocyte chemoattractant protein-1 in the interstitial cystitis patients

目的探讨单核细胞趋化因子-1（MCP-1）在间质性膀胱炎（IC）患者膀胱组织和尿液中的表达水平及其意义。方法根据美国国立糖尿病、消化、肾病协会IC诊断标准确诊女性IC患者35例，感染性膀胱炎（UD患者20例，肾囊肿患者25例作为正常对照组。IC患者平均年龄47（31～65）岁。主诉下腹酸胀／疼痛和夜尿次数多，伴有尿频尿急；已生育30例。均行24h排尿卡记录、IC症状及问题评分表（O’Leary—Sant评分表）、钾离子敏感试验（PST）和麻醉状态下水扩张后膀胱镜检查。膀胱镜检查获取3组患者膀胱组织和尿液样本，免疫组化染色方法观察MCP-1在IC组织中的表达分布，RTPCR技术测定3组膀胱组织中MCP-1 mRNA表达水平，酶联免疫吸附试验测定3组尿液标本中MCP-1水平。结果IC、UI、对照组尿液标本中MCP-1浓度分别为（74．1±36．9）、（280．6±68．9）、（10．8±6．9）pg／ml；膀胱组织中MCP-1相对定量值分别为76．2±24．0、99．5±30．1、36．1±14．1。IC组和U1组中组织／尿液中MCP-1表达水平均高于正常对照组，差异有统计学意义（P〈0．01）。IC组临床症状评分为（14．9±1．8）分，与MCP1升高水平呈正相关（r=0．686）。结论IC患者膀胱组织和尿液中MCP-1表达升高，可能成为IC诊断的非特异性免疫指标之一。

Objective To investigate the levels of monocyte chemoattractant protein-1（MCP-1） in the bladder tissue and urine of female interstitial cystitis（IC） patients. Methods Thirty-five IC patients according to the NIDDK IC diagnosis standard, 20 urinary infection （UI） patients and 25 asymptomatic controls were collected. All IC patients were accepted 24 hour voiding diaries, O＇ Leary Sant IC Questionnaires, potassium sensitivity test （PST） and cystoscopy under anesthetic. RT-PCR and ELISA analyses were used to determine the levels of MCP-1 in the bladder tissue and urine speci mens from women with IC-UI and controls. Immunohistochemistry staining was used to observe the distribution of MCP-1 in bladder tissue of IC. Results Urine MCP-1 was （74.1±36.9） pg/ml in IC patients, （280. 6±68. 9） pg/ml in UI patients and （10.8±6. 9） pg/ml in asymptomatic controls （P〈 0.01）. Tissue MCP-1 was 76.2±24.0 in IC patients, 99.5±30.1 in UI patients and 36. 1±14.1 in asymptomatic controls （P〈0. 01） by RTPCR analyses. The MCP-1 degree increased in IC patients was be tween UI patients and asymptomatic controls. The severity of IC clinical symptom was correlated with MCP-1 levels. Conclusions The changes in the levels of MCP-1 are associated with IC. After excluding urinary infection, it would be useful for early diagnosis of IC by increased level of MCP-1.