前列腺增生致膀胱出口梗阻患者逼尿肌神经生长因子表达及超微结构改变

目的通过人前列腺增生（BPH）致膀胱出口梗阻（BOO）后逼尿肌神经生长因子（NGF）表达及超微结构的研究揭示BOO后逼尿肌功能损害，了解BOO后膀胱逼尿肌的病理生理改变。方法免疫组化SABC法分实验组（梗阻组）33例和对照组（非梗阻组）15例，检测神经生长因子（NGF）的表达；超微结构实验组和对照组各5例，用电镜观察两组超微结构并对比。结果免疫组化梗阻组和非梗阻组NGF均表达，梗阻组表达明显高于非梗阻组（P〈0．01）；电镜部分对照组逼尿肌细胞排列整齐，细胞间隙有少量胶原纤维，细胞间以中间连接为主；实验组逼尿肌肥大，扭曲变形，排列不齐，增宽的细胞间隙中有大量的胶原纤维，细胞间中间连接减少，代替缝隙连接及桥粒连接等方式。结论BPH致BOO后膀胱逼尿肌细胞中NGF表达水平增高与逼尿肌不稳定（DI）及逼尿肌去神经改变等病理生理变化有关；BPH致BOO后逼尿肌不稳定及逼尿肌功能减退与逼尿肌形态改变及细胞连接等超微结构改变有关系。

NGF expression and ultrastructural changes in detrusor in patients with BOO caused by BPH

Objective To study the damage of human benign prostatic hyperplasia （BPH）-induced bladder outlet obstruction （BOO）on detrusor nerve growth factor （NGF）expression and pathophysiological changes on the ultrastructure. Methods The subjects were divided into 4 groups,33 cases in the experimental group （obstructive group）and 15 cases in the control group （non-obstruction group）, to detect the nerve growth factor （NGF）expression; 5 cases in the ultrastructual experimental group, and 5 cases in the control group to obseve the ultrastructure with electron microscope. Results NGF were expressed in both obstructive and non-obstructive group,with a significantly higher expression in the-obstructive group （P 〈0.01）. Under electron microscope, in the control group, detrusor cells were arranged in neat rows, with small amount of collagen fiber between cells;in the experimental group,detrusor cells were hypertrophy,distorted, arranged disorderly and the cell gap widened with a large amount of collagen fiber. Conclusion In BOO caused by BPH,the increased expression of NGF was related to detrusor instability （DI）and detrusor denervation. BPH-induced BOO detrusor instability and detrusor dys function is related to the morphological changes of detrusor ultrastructure and cell connections.