滥用氯胺酮致膀胱功能障碍患者膀胱组织中P2X3受体的表达及其临床意义

Expression of P2X3 receptor in ketamine induced bladder dysfunction and its clinical significance

目的:研究P2X3受体在滥用氯胺酮致膀胱功能障碍患者膀胱组织中的表达及其临床意义,讨论P2X3受体在滥用氯胺酮致膀胱功能障碍中的作用。方法:采用免疫组织化学方法分别检测36例滥用氯胺酮致膀胱功能障碍患者(试验组)和36例正常患者(对照组)膀胱组织中P2X3、M2、M3受体的表达情况,利用全自动显微镜及图像分析系统对免疫组化染色结果进行图像采集分析,测量其平均灰度值,同时比较两组间P2X3、M2、M3受体表达的差异。结果:P2X3受体主要在膀胱黏膜移行上皮细胞表达,试验组P2X3受体表达明显增强,与对照组比较差异有统计学意义(P<0.01);而M2、M3受体表达与对照组比较差异无统计学意义(P>0.01)。结论:滥用氯胺酮致膀胱功能障碍患者膀胱组织中P2X3受体表达显著增强,而M2、M3受体并未异常表达,提示P2X3受体上调可能在滥用氯胺酮致膀胱功能障碍中发挥关键作用。

Objective：To evaluate the expression of P2X3 receptor in ketamine induced bladder dysfunction,and discuss its clinical significance.Method：The expressions of P2X3,M2 and M3receptor in 36 cases of normal bladder and 36 cases of ketamine induced bladder dysfunction were detected by immunohistochemistry SABC assay.The image was acquired by automatic microscope and the mean gray scale value was analyzed by computer image analysis system.Result：P2X3receptor mainly expressed in transitional epithelium of the bladder.The expression of P2X3 receptor was low in the control group,which significantly increased in the ketamine group.The difference was statistically significant（P〈0.01）.However,the level of expressions of M2 and M3receptor were no statistically significant（P〉0.01）between two groups.Conclusion：The expression of P2X3 receptor significantly increases in the bladder tissue of the patient with abuse of katamine induced bladder dysfunction.However,there was no difference of the expression of M2 and M3receptor between the control and ketamine group.These data indicate that up-regulation of P2X3 receptor may underlie detrusor overactivity in cases of ketamine induced bladder dysfunction.