前列腺增生患者膀胱逼尿肌中多种生长因子变化的研究

Investigation of the changes of detrusor growth factors in patients with Benign Prostate Hyperplasia

目的探讨前列腺增生症患者膀胱逼尿肌功能改变与多种生长因子的关系。方法选择51例前列腺增生者膀胱逼尿肌标本,其中30例逼尿肌功能正常(稳定组),21例逼尿肌不稳定(不稳定组)。同时选择非尿路梗阻者15例为对照组,取膀胱逼尿肌标本。应用免疫组化方法检测膀胱逼尿肌中转化生长因子(TGF)、碱性成纤维生长因子(bFGF)、神经生长因子(NGF)的表达情况,同时比较各组之间的差异。结果 TGF的表达在稳定组、不稳定组及对照组分别为76.67%、90.48%及40.00%,三组之间的差异有统计学意义(P<0.01)。bFGF的表达在稳定组、不稳定组及对照组的表达分别为93.33%、90.48%及73.33%,稳定组、不稳定组的表达均高于对照组,并且与对照组比较差异有统计学意义(P<0.01)。NGF的表达在稳定组、不稳定组及对照组的表达分别为73.33%、85.71%及53.33%,三组之间的差异有统计学意义(P<0.01)。结论 BPH患者膀胱出口梗阻后逼尿肌中TGF、NGF表达的增高可能是其收缩功能改变导致膀胱不稳定的分子学基础。

Objective To study the relationship of detrusor dysfunction and growth factors in patients with Benign Prostate Hyperplasia（BPH）. Methods We took the muscular tissue of bladder wall from 51 patients with BPH and 15 pa-tients without urinary tract obstruction, 30 cases with normal detrusor function, and 21 cases of detrusor instability among 51 cases of Benign Prostate Hyperplasia. Immunohistochemical method was applied to detect the expression of the transfor-mation growth factor （TGF）、alkaline into fiber growth factors （bFGF）、nerve growth factor （NGF）in detrusor, at the same time, the difference between groups were compared. Results The expression rates of TGF were 76.67%, 90.48%and 40%in the stable group, the unstable group and the control group respectively （P＆lt; 0.01）. The expression rates of bFGF were 93.33%, 90.48% and 73.33% in the stable group, in the unstable group and the control group, respectively. bFGF in the stable group and in the unstable group was significantly higher than that in the control group （P＆lt;0.01）, and their expres-sion in the unstable group was significantly higher than that in the stable group （P＆lt; 0.01）.The expression of bFGF in the stable group and in the unstable group was significantly higher than that in the control group （P＆lt; 0.01）. The expression rates of NGF were 73.33%, 85.71%and 53.33%in the stable group, the unstable group and the control group, respectively （P＆lt;0.01）. Conclution The expression increase of TGF and NGF in the BPH might be the molecular basis of the detrusor function change after bladder outlet obstruction.