良性前列腺增生合并膀胱过度活动症患者膀胱黏膜毒蕈碱型胆碱能受体M2、M3亚型的表达及临床意义  

Expression and Clinical Significance of Muscarinic Cholinergic Receptor M2and M3Subtypes in Patients with Benign Prostatic Hyperplasia and Overactive Bladder

作　　者：张进生[1] 李玮[1] 刘宁[1] 渠渊[1] 王立茹[2] 冯超[1] 吴宗山[1] 柴军[1] 张前[1] 刘春林[1] 刘良颖[1] 

机构地区：[1]首都医科大学附属复兴医院泌尿外科,北京100038 [2]首都医科大学附属复兴医院血液科,北京100038

出　　处：《中国微创外科杂志》2014年第8期747-750,共4页Chinese Journal of Minimally Invasive Surgery

基　　金：首都市民健康项目培育(Z131100004013013)

摘　　要：目的探讨良性前列腺增生（benign prostatic hyperplasia，BPH）合并膀胱过度活动症（overac tivebladder，OAB）患者膀胱黏膜毒蕈碱型胆碱能受体（muscarinic cholinergic receptor，M受体）M2、M3亚型表达水平的变化及临床意义。方法分析2012年5月～2013年3月20例BPH患者的国际前列腺症状评分（international prostate syndrome scoring，IPSS）、生活质量评分（quality oflife，QOL）、膀胱过度活动症症状评分（OAB syndrome scoring，OABSS）和尿动力学检查。根据OABSS评分结果将其分为BPH组（9例）及BPH并OAB组（11例）。2组均在膀胱镜下钳取膀胱黏膜，经逆转录聚合酶链式反应（reversetranscription-polymerase chainreaction，RT-PCR）检测M受体M2、M3亚型mRNA的表达水平。M2、M3受体mRNA表达水平采用相对于内参基因mRNA表达的相对值△Ct值表示。比较2组M2、M3受体表达水平及相关性。结果M2、M3受体表达的ACt值BPH组明显低于BPH并OAB组（M2的△Ct值：-0．1544±0．641VS．0．5624±0．762，t=-2．241，P=0．038；M3的△Ct值：2．5344±0．816VS．3．6394±1．019，t=-2．630，P=0．017），说明BPH组M2、M3表达水平均高于BPH并OAB组。2组M2；M3分别为中位数6．5206（2．35～17．33）和7．9447（2．10～23．83）（Z=-1．102，P=0．271）。同组比较，2组M3表达水平均高于M3（t=-7．776，P=0．000；t=-8．018，P=0．000）。M3表达水平与OABSS和QOL评分呈负相关（r=-0．466，P=0．039；r=-0．496，P=0．026）。结论BPH合并OAB症状的患者，其膀胱黏膜M2、M3表达水平下降，且M2：M3比例在合并OAB后有升高的趋势，在OAB发病中起一定作用。M3表达的下降，加重了OAB的程度，降低了患者的生活质量。Objective To investigate the changes and significance of the expression of the M2 and M3 receptors of the urinary bladder mucosa in patients with benign prostatic hyperplasia （BPH） and overactive bladder （OAB）. Methods From May 2012 to February 2013, 20 cases of BPH were studied on the International Prostate Syndrome Scoring （ IPSS）, Quality Of Life （ QOL）, OAB syndrome scoring （OABSS）, and urodynamics. According to OABSS results, the patients were divided into either BPH group （n = 9） or BPH and OAB group （ n = 11 ）. Mucosa biopsies under the cystoscopy were performed in all the cases. The expression of M2 ＆ M3 receptors was assayed by reverse transcription-polymerase chain reaction （RT-PCR）. The mRNA expression levels of M2 ＆ M3 receptors were indicated by the ACt values. Results The levels of ACt of M2 ＆ M3 receptors were significantly lower in the BPH group than those in the BPH ＋ OAB group, respectively [ M2 ： （ - 0. 154 ± 0. 641 ） vs. （0. 562 ± 0. 762）, t = - 2. 241, P = 0. 038 ; M3： （2. 534 ±0.816） vs. （3. 639 ± 1.019）, t = -2. 630, P =0. 017], which implied that the expression of M2 and M3 receptors was higher in the BPH group than that in the BPH ＋ OAB group. The median ratios of M2： M3 in both groups were respectively 6. 5206 （2.35 - 17.33） and 7. 9447 （2.10 -23.83） （Z = - 1. 102, P =0. 271 ）. In the same group, the expression of M2 was higher than M3 in both groups （t = -7. 776, P =0. 000; t = - 8. 018, P =0. 000）. The expression of M3 receptors was negatively correlated to OABSS （r = - 0. 466, P = 0. 039） and QOL （ r = - 0. 496, P = 0. 026）. Conclusions The expression of M2 and M3 receptors isdecreased and the ratio of M2： M3 is increased in patients with BPH and OAB, which may play an important role in the development of OAB. The decreasing of expression of M3 receptor exacerbates the OAB degree and reduces the quality of patients＇ life.

关 键 词：良性前列腺增生 膀胱过度活动症 膀胱黏膜 毒蕈碱型胆碱能受体 

分 类 号：R697.3[医药卫生—泌尿科学] R694.5[医药卫生—外科学]