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目的:探讨BPH患者下尿路症状(LUTS)与膀胱逼尿肌胶原含量之间的关系。方法:42例BPH患者行TURP术,年龄66~88岁,平均74岁。IPSS中度(8~19分)14例、重度(20~35分)28例。同时取12例原发单一Ta期膀胱肿瘤患者作为对照组,年龄67~82岁,平均75岁。两组患者在行经尿道手术过程中,从膀胱两侧壁取深部肌层组织进行活检,对活检的逼尿肌胶原蛋白进行Van Gieson(VG)染色,应用图像分析系统对染色切片中的胶原蛋白进行半定量测定。结果:BPH组膀胱逼尿肌标本胶原蛋白含量(44.2±7.8)%,明显高于对照组(19.2±4.5)%(P<0.01);IPSS重度患者逼尿肌胶原含量(48.5±6.2)%,明显高于中度患者(41.1±5.0)%(P<0.01)。结论:膀胱逼尿肌胶原沉积在梗阻性BPH患者的下尿路症状中起重要作用,并且与BPH患者解除梗阻后下尿路症状的持续性相关。
Objective: To investigate the relationship between lower urinary tract symptoms (LUTS) and bladder detrusor collagen content in patients with BPH. Methods: Forty-two BPH patients underwent TURP, aged 66-88 years, with an average of 74 years. IPSS moderate (8 to 19 points) in 14 cases, severe (20 to 35 points) in 28 cases. At the same time, 12 patients with primary Ta-stage bladder cancer were selected as the control group, with a mean age of 75 years (range, 67-82 years). During the transurethral resection of the urethra in both groups, the deep myometrial tissues were taken from both sides of the bladder for biopsy. Van Gieson (VG) staining was performed on detrusor collagen of the biopsy. Collagen in the stained sections was analyzed by image analysis system Semi-quantitative determination. Results: Collagen content of bladder detrusor muscle specimens was (44.2 ± 7.8)% in BPH group, which was significantly higher than that in control group (19.2 ± 4.5)% (P <0.01) , Significantly higher than that of moderate (41.1 ± 5.0)% (P <0.01). CONCLUSIONS: Detrusor bladder collagen deposition plays an important role in lower urinary tract symptoms in patients with obstructive BPH and is associated with the persistence of lower urinary tract symptoms after obstruction is relieved in patients with BPH.