良性前列腺增生患者尿动力学及逼尿肌超微结构的相关性研究

目的 探讨良性前列腺增生(BPH)患者尿动力学检查与膀胱逼尿肌超微结构的关系.方法 BPH组患者43例,平均年龄(69.5±6.0)岁;无膀胱出口梗阻的其他疾病患者21例为对照组,平均年龄(65.4±7.2)岁.2组患者均行尿动力学检查,透射电镜观察膀胱逼尿肌超微结构.比较2组患者尿动力学检查及逼尿肌超微结构情况.结果 BPH组和对照组患者国际前列腺症状评分分别为(21.1±3.0)和(7.6土1.4)分,P<0.01;最大尿流率分别为(7.7±1.3)和(14.9±2.3)ml/s,P<0.01;最大尿流率时逼尿肌收缩压分别为(60.1±11.o)和(48.7±7.1)cm H2o(1 cm HzO=0.098 kPa),P<0.05;梗阻系数分别为44.8±9.9和19.0±5.9,P<0.01;膀胱逼尿肌细胞线粒体相对密度分别为0.81±0.24和1.03±0.11,P<0.05;膀胱逼尿肌细胞间隙分别为(19.4±4.8)和(14.1±2.0)nm,P<0.05.结论 BPH患者逼尿肌细胞线粒体水肿、相对密度减低,是导致逼尿肌收缩力减弱的原因之一;同时由于细胞间隙增宽,导致逼尿肌收缩速度减慢或不协调,引起膀胱协调收缩力下降.

Urodynamics and ultrastructure of detrusor in patients with benign prostatic hyperplasia

Objective To evaluate the relationship between urodynamics and ultrastructure of bladder detrusor in patients with benign prostatic hyperplasia(BPH). Methods The ultrastructure of detrusor was studied by transmission electron microscopy in 43 cases of BPH(mean age 69.5±6.0 years)and 21 cases(mean age 65.4±7.2 years)of geriatric without bladder outlet obstruction(the controls).All the cases were performed urodynamic test. Results The IPSS(21.1±3.0 VS 7.6±1.4),maximum flow rate(7.7±1.3 ml/s VS 14.9±2.3 ml/s)and AG(44.8±9.9 VS 19.0±5.9)showed significant differences between the the BPH group and control group(P<0.01).Pdet-Qmax in the BPH group(60.1±11.0 cm H20)was higher than that in the control group(48.7±7.1 cm H2o) (P<0.05).The relative density of mitochondria in the BPH group(0.81±0.24)was lower than that in the control group(1.03±0.11)(P<0.05).The intercellular linkage in the BPH group(19.4±4.8 rim)was larger than the control group(14.1±2.0 nm)(P<0.05). Conclusions The swelling and reduction of the relative density of mitochondria could be seen in the bladder detrusor of BPH patients.The large intercellular linkage might be the reason of decrease the coordinate contractility of the blad-der detrusor.