间质性膀胱炎患者尿液中神经生长因子的表达及临床意义

Expression of nerve growth factor in urine of patients with interstitial cystitis and its clinical significance

目的探讨问质性膀胱炎（IC）患者尿液中神经生长因子（NGF）的表达及作为诊断和预后判断指标的价值。方法回顾性分析2013年1月至2017年1月收治的22例IC患者（IC组）的病例资料，男2例，女20例；年龄（48．5±12．8）岁；治疗前排尿次数（25．4．4-4．6）次，夜尿次数（4．6±0．5）次，最大膀胱容量（223．44-39．5）ml，国际前列腺症状评分（IPSS）（17．3±1．2）分，生活质量评分（QOL）（12．74-1．7）分。选取同期体检中心22例健康体检者作为对照组，男4例，女18例；年龄（40．2±8．7）岁；排尿次数（4．2±2．6）次，夜尿次数（1．14-0．4）次。采用ELISA法检测IC组治疗前及对照组的尿液NGF含量分别为（243．5±37．8）ng／L和（75．7±7．5）ng／L，两组差异有统计学意义（P〈0．05）。IC组采用透明质酸钠膀胱灌注治疗。比较IC组治疗前与治疗后1、3、6个月尿液NGF含量的差异，分析NGF含量与IC组症状的相关性。结果IC组治疗后1、3、6个月NGF的含量分别为（187．3±28．7）、（141．5±21．3）、（123．1±15．9）ng／L，与治疗前比较差异均有统计学意义（P〈0．05）。治疗后1、3、6个月的排尿次数分别为（21．7±5．2）、（17．2±3．9）、（14．6±3．8）次，夜尿次数分别为（3．8±0．6）、（2．9±0．8）、（1．7-4-1．1）次，最大膀胱容量分别为（258．7±40．2）、（289．6±37．1）、（305．2±40．4）rrd，IPSS分别为（15．1±2．4）、（12．4±1．8）、（9．8±1．3）分，QOL分别为（10．6±1．2）、（8．5．4-1．5）、（7．1±1．3）分，与治疗前比较差异均有统计学意义（P〈0．05）。多元线性回归分析结果显示，IC患者尿液中NGF含量与排尿次数、夜尿次数、QOL、IPSS、最大膀胱容量均呈明显正相关（P〈0．05）。结论IC患者尿液中NGF含量显著高于正常人，其与患者症状严重程度呈正相关。

Objective Evaluate the clinical value of nerve growth factor （NGF） in patients with interstitial cystitis for diagnosis and predicting the prognostic. Methods From January 2013 to January 2017,22 cases of interstitial cystitis patients , including 20 female cases and 2 male cases,were collected. Their mean age was （48.5 ± 12.8） years old. The average frequency of urination was 25.4 ±4.6 before treatment. The average frequency of nocturia was 4.6± 0. 5. The average maximal bladder volume was （223.4 ± 39.5 ） ml. Their IPSS and QOL scores were 17.3 ± 1.2,12.7 ± 1.7, respectively. Meanwhile,22 healthy volunteers,including 18 female cases and 4 male cases,were collected. Their mean age was （40.2 ± 8.7 ） years old. The average frequency of urination was 4.2 ± 2.6 before treatment. The average frequency of nocturia was 1.1 ± 0.4. Urine NGF of these patients were collected before and after sodium hyaluronate bladder perfusion treatment, and the levels of NGF were detected by ELISA method. The correlationship between NGF and the severity of the symptoms were evaluated before and after treatment. Results After 1, 3 and 6 months＇ treatment, the levels of NGF were dropped from （243.5 ± 37.8 ） ng/L to （ 187.3 ± 28.7 ） ng/L, （141.5 ± 21.3）ng/L and （123.1±15.9 ） ng/L, which was positively associated with the degree of clinical symptom. The number of urination droppted from 25.4 ± 4.6 to 21.7 ± 5.2, 17.2 ±3.9 and 14.6 ± 3.8. The number of nocturia was dropped from 4.6±0.5 to 3.8±0.6,3.0±0.8 and 1.7±1. 1. The maxinmm volume of bladder increased from （ 223.4 ±39.5 ） ml to （ 258.7 ± 40.2 ） ml, （ 289.6 ± 37.1 ） ml and （305.2 ± 40.4） ml. The IPSS scores dropped from 17.3 ＋ 1.2 to 15.1 ＋ 2.4, 12.4 ± 1.82 and 9.8 ± 1.4. The QOL scores dropped from 12.7±1.7 to 10.6±1.2, 8.5＋1.5 and 1.7±1.3（P〈0.05）. The logistic regression analysis showed the level of NGF in IC patients has positive relationship with frequency of urination, nocturia, QOL scores, IPSS scores and maximal bladder volume （ P 〈 0.05 ）. Conclusions The level of NGF in urine is associated with IC symptom severity and NGF has the potential to be used as a marker for the diagnosis of IC.