女性膀胱过度活动症患者内源性硫化氢调控作用的研究

The regulatory role of hydrogen sulfide in female patients with overactive bladder

目的探讨女性膀胱过度活动症(overactive bladder,OAB)患者膀胱组织中内源性硫化氢(hydrogen sulfide,H2S)水平的变化及其与排尿功能障碍的关系。方法选取女性OAB患者(OAB组)及非OAB受试者(对照组)各50例,观察两组平均24 h排尿次数、24 h尿失禁次数、初始尿意容量(first desire to void,FDV)及最大尿意容量(maximal volume atmicturtion desire,MV),评判最大尿流率(maximum urine streaming rate,Qmax)及排尿量(voiding volume,VV),完成膀胱过度活动症评分(overactive bladder symptom score,OABSS)。两组入选对象均行膀胱镜检查,并于非膀胱三角区区域收集膀胱肌肉组织,应用敏感硫电极法测定膀胱肌肉组织匀浆中H2S含量。结果 OAB组患者与对照组受试者膀胱组织中H2S水平差异有统计学意义(P<0.05)。OAB组H2S水平与平均24 h排尿次数及24 h尿失禁次数呈正相关,与FDV、MV、VV、Qmax呈负相关。结论女性OAB患者膀胱组织内H2S水平较正常女性明显升高,H2S含量作为一种有效、客观的监测指标,对评价女性OAB患者排尿功能障碍的严重程度及治疗效果具有一定的临床意义。

Objective To investigate the relationship between blander tissue endogenous H2S .and severity of urinary dysfunction in female patients with overactive bladder（OAB）. Methods One hundred female patients with and without OAB were randomly divided into two groups,50 in each group. Average 24 h urine number, average 24 h urine incontinence, first desire to void （ FDV）, maxi- mal volume atmieturtion desire（MV）, maximum urine streaming rate（ Qmax）, and voiding volume（VV） were observed to calculate the overactive bladder symptom score（OABSS）. Cystoscopy was carried out for all of 100 patients, and bladder muscle tissue was biopsied for detecting the endogenous H2S by a modified sulfide electrode method. Results H2S concentrations in the bladder muscle tissue showed a skew distribution. There was a statistical difference between the two groups（ P 〈 0. 05 ）. The endogenous H2S concentrations were positively correlated with the average 24 h urine number and average 24 h urine incontinence. However, it was negatively correlated with FDV, MV, Qmax and VV. Conclusion The detection of bladder tissue endogenous H2 S can be used as an effective and objective monitoring method to evaluate the severity of female patients with OAB and curative efficacy.