BPH患者下尿路症状与逼尿肌胶原含量的定量分析

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-T8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VanGieson（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士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〈O．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。

Correlation between detrusor collagen content and lower urinary tract symptoms in BPH patients

Objective： To explore relationships between the collagen content of detrusor specimens and lower urinary tract symptoms（LUTS） in BPH patients. Methods： Forty-two patients （mean age 74, range 66 to 88 years） with symptomatic urodynamically obstructed BPH undergoing transurethral resection of the prostate were analyzed. Twelve patients （mean age 75, range 67 to 82 years） undergoing transurethral resection of the bladder for primitive Ta bladder cancer, with no significant urinary symptoms were chosen as the control group. During the transurethral surgical procedure in two groups biopsies were performed deep through the muscular layer from either of the lateral bladder walls. Computerized morphometric analysis of the stained sections was performed with an image analysis system, and a percentage of collagen fibers was extracted through morphological filtering and ex- pressed as a mean percentage of the total bioptic area. Results： Collagen content in bladder detrusor specimens was significantly higher in patients with BPH compared with the control group（44.2%±7.8%, and 19.2%0 ±4.5% of bioptic area, respectively P〈0.01）. Mean detrusor collagen content was clearly higher in patients with IPSS se vere symptoms than in patients with IPSS moderate symptoms（48.5 % ± 6.2 %, and 41.1 %± 5.0 %, respectively P〈0.01）. Conclusion： All the above data supports the important role of detrusor collagen in determining LUTS in obstructive BPH. Collagen neoformation could probably have a role in the post operative persistence of LUTS in patients undergoing surgery for BPH.