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目的检测前列腺增生后不同逼尿肌结构功能状态下肌聚糖(sarcoglycan,SG)的表达,分析SG的表达与逼尿肌收缩功能改变的相关性及临床意义。方法分析56例前列腺增生患者逼尿肌标本,其中,逼尿肌收缩力下降组26例,逼尿肌收缩力正常组30例,选择同期因膀胱肿瘤住院患者25例作为阴性对照组;常规检查收集患者年龄、前列腺体积、PSA指标、Qmax和Pdet-Qmax尿动力学参数等临床数据;所有膀胱逼尿肌均经HE染色病理学检查;用免疫组织化学技术和实时定量荧光PCR(real-time PCR)技术分别检测逼尿肌中SG的α、β、γ亚基的m RNA和蛋白水平;用等级相关法分析各组之间的差异以及SG表达与临床数据的关系。结果与对照组相比,下降组的平滑肌肌纤维断裂,密度降低,排列稀疏,细胞之间的间隙增宽,且可见结缔组织增生及大量炎性细胞浸润,正常组的平滑肌肌纤维排列紧密,无变性坏死等表现;3组两两相比较,下降组SG的α、β、γ亚基m RNA和蛋白表达水平显著性下降(P<0.05),而正常组其表达量未见显著性改变(P>0.05);前列腺增生患者中SG的α、β、γ亚基蛋白的表达与最大尿流率时逼尿肌压(Pdet-Qmax)呈正相关(P<0.01)。结论 SG表达的下降与前列腺增生后造成膀胱逼尿肌的收缩力下降有关,检测SG表达有助于了解前列腺增生后造成逼尿肌收缩力改变的分子生物学机制,以期为今后相关的诊治提供新的思路及理论基础。
Objective To detect the expression of sarcoglycan (SG) under different functional detrusor structures after prostatic hyperplasia (BPH), and to analyze the correlation between SG expression and detrusor contractility and its clinical significance. Methods 56 cases of prostatic hyperplasia patients detrusor specimens, including detrusor contractility decreased group of 26 patients with detrusor contractility normal group of 30 patients selected for the same period due to bladder cancer inpatients 25 patients as a negative control group; routine examination The clinical data of patient’s age, prostate volume, PSA index, Qmax and Pdet-Qmax urodynamic parameters were collected. All detrusor deformities were examined by HE staining and immunohistochemistry and real-time quantitative PCR PCR) were used to detect the m RNA and protein levels of α, β, γ subunits of SG in detrusor respectively. The differences between groups and the relationship between SG expression and clinical data were analyzed by rank correlation analysis. Results Compared with the control group, the smooth muscle fibers of the descending group had a lower fracture, a lower density, a sparse arrangement, a widened gap between the cells, and more connective tissue hyperplasia and a greater number of inflammatory cell infiltration. The smooth muscle fibers of the normal group were arranged closely and without degeneration The expression of m RNA and protein of α, β, γ subunit of SG in descending group were significantly decreased (P <0.05), while the expression in normal group had no significant change (P > 0.05). The expression of α, β, γ subunit protein in SG in patients with benign prostatic hyperplasia was positively correlated with Pdet-Qmax (P <0.01). Conclusions The decreased expression of SG is associated with decreased contractility of detrusor of the bladder after prostatic hyperplasia. Detecting SG expression is helpful to understand the molecular biological mechanism of detrusor contractility after benign prostatic hyperplasia, with a view to providing relevant diagnosis and treatment New ideas and theoretical basis.