琥珀酸索利那新对女性膀胱过度活跃症患者生长相关蛋白-43及尿动力学影响研究

Research of the effect of solifenacin succinate on growth-associated protein 43 and urodynamics of female patients with overactive bladder

目的探讨琥珀酸索利那新对女性膀胱过度活跃症患者生长相关蛋白-43及尿动力学影响效果。方法选取我科收治的女性膀胱过度活跃症患者60例,随机分为两组。对照组30例,予常规异搏定80mg加生理盐水80mL配置的无菌溶液进行膀胱灌注,每次保留1h,并每15min变换体位,2次/周,1周为1个疗程,治疗4个疗程。实验组30例,予琥珀酸索利那新5mg晚睡前口服,1周为1疗程,治疗4个疗程。正常组30例,选取健康女性,不予任何治疗手段。治疗结束后,对比各组患者生长相关蛋白-43及尿动力学水平变化情况,并通过PCR逆转录聚合酶链反应检测各组生长相关蛋白-43基因表达水平。结果 (1)经治疗,两组患者生长相关蛋白-43及磷酸化生长相关蛋白水平不同程度降低,实验组较对照组生长相关蛋白-43明显降低(P<0.05);(2)治疗后两组患者尿动力学均不同程度恢复,实验组尿量、最大尿流率、残余尿量、初始尿意容积较对照组明显改善(P<0.05);(3)治疗后,两组生长相关蛋白-43及磷酸化蛋白水平均不同程度改善,实验组PCR、生长相关蛋白-43、磷酸化蛋白较对照组明显降低(P<0.05)。结论琥珀酸索利那新能够明显改善女性患者膀胱过度活跃症状,降低生长相关蛋白-43水平,并抑制相关蛋白磷酸化程度,从而改善膀胱刺激症状,降低膀胱内壁敏感性,改善尿动力学水平。

Objective To investigate the clinical effect of solifenacin succinate on growth-associated protein 43 （GAP-43） and urodynamics of female overactive bladder. Methods 60 female patients with overactive bladder were chosen and randomly divided into control group （CG） and trial group （TG）, each group n=30. CG received intra- vesical instillation of sterile solution （verapamil 80 mg and normal saline 80 ml）, which retaining one hour in each time and changing posture per 15 minutes in this time, twice per week. TG received oral administration of solifena- cin succinate （5 mg,once before bed-time）. Treatment lasted for 4 weeks in both groups. 30 healthy women were chosen as normal group （NG） and no treatment was given. Changes of GAP-43 and urodynamics in three groups were compared on the end of treatment, and gene expressions of GAP-43 in three groups were detected by using reverse transcription polymerase chain reaction （RT-PCR）. Results There were differently degree of depression of level of GAP-43 and phosphorylation GAP-43 （p-GAP-43） in both group patients after treatment, and level of GAP-43 in TG was markedly lower than CG, there were statistical significantly differences （P〈0.05）. Urodynamies in both TG and CG had different degree of recovery on the end of treatment. Urine volume, maximum urinary flow rate, residual urine volume and initial urine volume in TG showed more obviously improved and there were statistical significantly differences （P〈0.05）. Levels of protein expression of GAP-43 and p-GAP-43 in both groups improved in differently degree, and there were statistical significantly differences （P〈0.05）. Conclusion Solifenacin succinate can improve the symptoms of female overactive bladder and ameliorates urodynamics by reduced the level of GAP-43 and inhibited the degree of phosphorylation.