间质性膀胱炎的炎症分级与神经纤维密度及临床症状的关系

目的探讨间质性膀胱炎（IC）患者膀胱组织的炎症分级与神经纤维密度及临床症状的关系，明确“炎症-神经”相互作用在IC致病中的作用。方法51例IC患者（男9例，女42例）均完成VAS疼痛评分、尿频评分、尿急评分。膀胱活检标本切片后行HE染色检测炎症分级和免疫组织化学检测PGP9．5阳性神经纤维的表达情况。结果IC轻度炎症组、中度炎症组、重度炎症组的PGP9．5阳性神经纤维密度分别为（4．45±1．53）／cm^2、（5．07±1．74）／cm^2、（5．63±1．82）／cm^2，三组比较差异有统计学意义（P中／轻=0．031，P重／中=0．033）；炎症分级越高，PGP9．5阳性神经纤维密度就越高（r=45，P〈0．001）。三组患者的尿频评分比较差异有统计学意义（P中／轻：0．032，P重／中=0．028），尿频评分与炎症分级成正相关性（r=0．34，P=0．012）；三组患者的尿急评分比较差异有统计学意义（P中／轻=-0．013，P重／中=0．035），尿急评分与炎症分级成正相关性（t=0．38，P=0．005）；三组患者的疼痛评分比较差异有统计学意义（P中／轻=0．008，P重／中=0．003），疼痛评分与炎症分级成正相关（r=0．44，P=0．001）。结论IC患者膀胱组织中炎症分级越高，PGP9．5阳性神经纤维密度就越高；而且IC患者的尿频、尿急、疼痛等症状的评分与膀胱组织的炎症分级成正相关性，这些结果提示“炎症-神经”相互作用可能是IC的致病机制之一。

The relationship among the grade of inflammation,nerve fibers density and clinical symptoms in patients with interstilial cystitis

Objective To explore the relationship among the grade of inflammation, nerve fibers density and clinical symptoms m in patients with interstitial cystitis（IC）, in order to understand the role of the interaction between inflammation and neurons in the pathogenesis of IC. Methoda 51 patients （9 males and 42 females） with IC had completed questionnaires of VAS pain scores, urinary frequency scores and urgency scores. Bladder biopsy specimens underwent HE staining and detecting the grade of inflammation, as well as immunohistochemistry of the PGP9.5 monoclonal antibody and nerve fibers counting. Results The density of PGP9.5 positive nerve fibers in mild inflammation group, moderate inflammation group and severe inflammation group were （4.45 ±1.53）/cm^2, （5.07±1.74）/cm^2, （5.63 ±1.82）/cm^2 respectively, and the differences between groups were statistically significant （Pmoderate/mild=0.031, P severe/moderate=0.033）. The higher grade of inflammation in IC bladder tissues was related to the higher density of PGP9.5 positive nerve fibers （r=0.45, P〈0.001）. The differences of urinary frequency scores among those groups were statistically significant （P moderate/mild =0.032, P severe/moderate=0.028）; the grade of inflammation had a positive correlation with urinary frequency scores （r=0.34, P=0.012）. The differences of urinary urgency scores among those groups were statistically significant （P moderate/mild= 0.013, P severe/moderate=0.035 ）; the grade of inflammation had a positive correlation with urinary frequency scores （r=0.38, P=-0.005）. The differences of pain scores among those groups were statistically significant （P moderate/mild=0.008, P severe/moderate=0.003）; the grade of inflammation had a positive correlation with urinary frequency scores （t=0.44, P=0.001）. Conclusions The higher grade of inflammation in IC bladder tissues was related to higher density of PGP9.5 positive nerve fibers; and the grade of inflammation had a positive relationship with symptoms scores of urinary frequency, urgency, pain in IC patients. These results suggested the interaction between inflammation and neurons might have an important role in the pathogenesis of IC.