间质性膀胱炎各层组织中神经纤维过表达及其临床意义

The overexpression of nerve fibers in different layers of bladder tissues in patients with interstitial cystitis and their clinical significance

目的探讨间质性膀胱炎(IC)患者的膀胱各层组织神经纤维的表达情况及其与临床症状的相关性,明确其在IC致病中的意义。方法 51例IC患者为实验组(男9例,女42例),27例非IC患者的正常膀胱组织为对照组,实验组进行O’Leary-Sant、VAS评分和膀胱镜检,两组均行PGP9.5单克隆抗体免疫组化和神经纤维计数。结果两组膀胱组织的神经纤维密度(NF-PN)分别为5.07±1.33/cm2、3.82±1.18/cm2,差异具有统计学意义(P=0.001),其中两组黏膜层、黏膜下层、逼尿肌层的NF-PN的比较存在统计学差异(P值分别为0.002、0.019、0.016)。O'Leary-Sant评分中的ICSI、ICPI与黏膜下层、逼尿肌层的NF-PN有关(P均<0.05),而VAS评分与黏膜层、黏膜下层的NF-PN有关(P均<0.01)。结论 IC患者膀胱组织的黏膜层、黏膜下层、逼尿肌层的神经纤维密度明显比对照组的高;膀胱疼痛症状与黏膜层、黏膜下层的神经纤维增多有关,而尿频、尿急症状与黏膜下层、逼尿肌层的神经纤维增多有关,表明膀胱组织的神经纤维增多可能是IC的致病因素之一。

Objective To search the expression nerve fibers in different lays of bladder tissues of interstitial cystitis （IC） and their relationship with clinical symptoms, in order to understand their role in the pathogenesis of IC. Materials and Methods Fifty-five cases of IC patients as the experimental group （9 male, 42 female） and 27 cases normal bladder tissues as control group. O＇Leary-Sant and VAS scores, bladder microscopic examination and hydrodistention were used in the experimental group. All biopsies of patients were underwent immunohistochemistry of the PGP9.5 monoclonal antibody and nerve fibers counting. Results The nerve fibers density of the bladder tissue in two groups （defined as the NF-PN） respectively were 5.07 ± 1.33/cm^2 and 3.82 ± 1.18/cm^2 （P=0.001）; There was a significant difference in the NF-PN of mucous layer, submucosa layer, detrusor layer between the two groups （P values respectively were 0.002, 0.019, 0.016）. The ICSI and ICPI of O＇Leary-Sant scores were related to the NF-PN of submucosa and detrusor layer （all P values were 〈0.05）, and VAS scores were related to the NF-PN of the mucous and submucosa layer （all P values were 〈0.01）. Conclusions The nerve fibers density in the mucosa, submucosa and detrusor layers of bladder tissues in IC were significantly higher than the control group, and the symptoms of bladder pain in IC patients were related to the NF-PN of the mucous and submucosa layer; The symptoms of frequency and urgency were related to the NF-PN of submucosa and detrusor layer. We believe that the increase expression of nerve fibers in bladder tissues may play a role in the pathogenesis of IC.