膀胱黏膜毒蕈碱型胆碱能受体密度与前列腺术后膀胱痉挛的相关性研究
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摘要
目的探讨膀胱黏膜毒蕈碱型胆碱能受体(M受体)M2、M3亚型的密度与前列腺电切术后膀胱痉挛的相关性。方法选取2012年5月-2015年5月医院收治的良性前列腺增生(BPH)患者作为研究对象,将其分为合并膀胱过度活动症(OAB)观察组和不合并OAB对照组,再将观察组分为发生膀胱痉挛组及不发生膀胱痉挛组,比较各组M2、M3受体的密度及其相关性。结果观察组术后膀胱痉挛的发生率高于对照组;观察组M2、M3受体密度均低于对照组;观察组中发生膀胱痉挛患者的M3受体密度低于不发生膀胱痉挛患者的M3受体密度。结论膀胱黏膜M3受体密度与前列腺术后发生膀胱痉挛存在相关性,提示M3受体可能参与膀胱痉挛的发病机制。
Objective To analyze the correlation of the bladder spasm after prostate surgery and the density of M2 and M3 muscarinic receptors in bladder mucosa. Methods Patients with benign prostatic hyperplasia(BPH) in our hospital from May 2012 to May 2015 were enrolled as research objects and divided into observation group [BPH with overactive bladder(OAB)] and control group(BPH without OAB). And then the observation group was further divided into bladder spasm subgroup and non-spasm subgroup. The density of M2 and M3 receptors were determined and their correlations with bladder spasm were analyzed. Results The rate of bladder spasm of the observation group was higher than that of the control group. The density of M2 and M3 muscarinic receptors of the observation group was lower than that of the control group. The density of M3 muscarinic receptor in the bladder spasm subgroup was lower than that in the non-spasm subgroup.Conclusions There is a correlation between bladder spasm after prostate surgery and density of M3 muscarinic receptor in bladder mucosa, suggesting M3 receptor may be involved in the pathogenesis of bladder spasm and it can be used as a target to design drugs for prevention and control of bladder spasm.
Objective To analyze the correlation of the bladder spasm after prostate surgery and the density of M2 and M3 muscarinic receptors in bladder mucosa. Methods Patients with benign prostatic hyperplasia(BPH) in our hospital from May 2012 to May 2015 were enrolled as research objects and divided into observation group [BPH with overactive bladder(OAB)] and control group(BPH without OAB). And then the observation group was further divided into bladder spasm subgroup and non-spasm subgroup. The density of M2 and M3 receptors were determined and their correlations with bladder spasm were analyzed. Results The rate of bladder spasm of the observation group was higher than that of the control group. The density of M2 and M3 muscarinic receptors of the observation group was lower than that of the control group. The density of M3 muscarinic receptor in the bladder spasm subgroup was lower than that in the non-spasm subgroup.Conclusions There is a correlation between bladder spasm after prostate surgery and density of M3 muscarinic receptor in bladder mucosa, suggesting M3 receptor may be involved in the pathogenesis of bladder spasm and it can be used as a target to design drugs for prevention and control of bladder spasm.
引文
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[4]龚海华,钱良军.琥珀酸索利那新、盐酸坦索罗辛单用或联用治疗经尿道离子束刀前列腺切除术后膀胱过度活动症效果对比[J].实用药物与临床,2014,17(6):774-777.
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[7]张进生,李玮,刘宁,等.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、亚型的表达及临床意义[J].中国微创外科杂志,2014,8(14):747-750.
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[11]YAMADA S,KURAOKA S,OSANO A,et al.Characterization of bladder selectivity of antimuscarinic agents on the basis of in vivo drug-receptor blinding[J].Int Neurourol J,2012,16(3):107-115.
[12]YOSHIDA A,SEKI M,NASRIN S,et al.Characterization of muscarinic receptors in the human bladder mucosa:direct quantification of subtypes using 4-DAMP mustard[J].Urology,2011,78(3):1357-1366
[13]CHAIYAPRASITHI B,MANG C F,KILBINGER H,et al.Inhibition of human detrusor contraction by a urothelium derived factor[J].J Urol,2003,170(5):1897-1900.
[14]HAWTHORN M H,CHAPPLE C R,COCK M,et al.Urothelium-derived inhibitory factor(s)influence on detrusor muscle contractility in vitro[J].Br J Pharmacol,2000,129(3):416-419.
[15]MORO C,UCHIYAMA J,CHESS-WILLIAMS R.Urotheliallamina propria spontaneous activity and the role of M3 muscarinic receptors in mediating rate responses to stretch and carbachol[J].Urology,2011,78(6).DOI:10.1016/j.urology.2011.08.039.
[16]BIRDER L A,RUGGIERI M,TAKEDA M,et al.How does the urothelium affect bladder function in health and disease?ICI-RS 2011[J].Neurourol Urodyn,2012,31(3):293-299.
[17]ANDERSSON K E.Muscarinic acetylcholine receptors in the urinary tract[J].Handb Exp Pharmacol,2011,1(202):319-344.
[18]HEDLUND P,STRENG T,LEE T,et al.Effects of tolterodine on afferent neurotransmission in normal and resiniferatoxin treated conscious rats[J].J Urol,2007,178(1):326-331.
[19]KOVYAZINA I V,TSENTSEVITSKY A N,NIKOLSKY E E.Identification of the muscarinic receptor subtypes involved in autoregulation of acetylcholine quantal release from frog motor nerve endings[J].Dokl Biol Sci,2015,460(1):5-7.
[20]MATSUMOTO Y,MIYAZATO M,YOKOYAMA H,et al.Role of M2 and M3 muscarinic acetylcholine receptor subtypes in activation of bladder afferent pathways in spinal cord injured rats[J].Urology,2012,79(5).DOI:10.1016/j.urology.2012.01.022.
[2]KNUTSON T,EDLUND C,FALL M,et al.BPH with coexisting overative bladder dysfunction-an everyday urological dilemma[J].Neurourol Urodyn,2001,20(3):237-247.
[3]高中伟,辛士永,张建国,等.坦索罗辛联合索利那新在治疗轻中度良性前列腺增生合并膀胱过度活动症中的疗效分析[J].中华男科学杂志,2014,20(3):239-243.
[4]龚海华,钱良军.琥珀酸索利那新、盐酸坦索罗辛单用或联用治疗经尿道离子束刀前列腺切除术后膀胱过度活动症效果对比[J].实用药物与临床,2014,17(6):774-777.
[5]HOMMA Y,KAKIZAKI H,YAMAQUCHI O,et al.Assessment of overactive bladder symptoms:comparison of 3-day bladder diary and the overactive bladder symptoms score[J].Urology,2011,77(1):60-64.
[6]PATRA P B,PATRA S.Research findings on overactive bladder[J].Curr Urol,2015,8(1):1-21.
[7]张进生,李玮,刘宁,等.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、亚型的表达及临床意义[J].中国微创外科杂志,2014,8(14):747-750.
[8]梅骅,陈凌武,高新,等.泌尿外科手术学[M].第3版.北京:人民卫生出版社,2008:425-426.
[9]EGLEN R M.Overview of muscarinic receptor subtypes[J].Handb Exp Pharmacol,2012,1(208):3-28.
[10]SIGALA S,MIRABELLA G,PERONI A,et al.Differential gene of cholinergic muscarinic receptor subtypes in male and female normal human urinary bladder[J].Urology,2002,60(4):719-725.
[11]YAMADA S,KURAOKA S,OSANO A,et al.Characterization of bladder selectivity of antimuscarinic agents on the basis of in vivo drug-receptor blinding[J].Int Neurourol J,2012,16(3):107-115.
[12]YOSHIDA A,SEKI M,NASRIN S,et al.Characterization of muscarinic receptors in the human bladder mucosa:direct quantification of subtypes using 4-DAMP mustard[J].Urology,2011,78(3):1357-1366
[13]CHAIYAPRASITHI B,MANG C F,KILBINGER H,et al.Inhibition of human detrusor contraction by a urothelium derived factor[J].J Urol,2003,170(5):1897-1900.
[14]HAWTHORN M H,CHAPPLE C R,COCK M,et al.Urothelium-derived inhibitory factor(s)influence on detrusor muscle contractility in vitro[J].Br J Pharmacol,2000,129(3):416-419.
[15]MORO C,UCHIYAMA J,CHESS-WILLIAMS R.Urotheliallamina propria spontaneous activity and the role of M3 muscarinic receptors in mediating rate responses to stretch and carbachol[J].Urology,2011,78(6).DOI:10.1016/j.urology.2011.08.039.
[16]BIRDER L A,RUGGIERI M,TAKEDA M,et al.How does the urothelium affect bladder function in health and disease?ICI-RS 2011[J].Neurourol Urodyn,2012,31(3):293-299.
[17]ANDERSSON K E.Muscarinic acetylcholine receptors in the urinary tract[J].Handb Exp Pharmacol,2011,1(202):319-344.
[18]HEDLUND P,STRENG T,LEE T,et al.Effects of tolterodine on afferent neurotransmission in normal and resiniferatoxin treated conscious rats[J].J Urol,2007,178(1):326-331.
[19]KOVYAZINA I V,TSENTSEVITSKY A N,NIKOLSKY E E.Identification of the muscarinic receptor subtypes involved in autoregulation of acetylcholine quantal release from frog motor nerve endings[J].Dokl Biol Sci,2015,460(1):5-7.
[20]MATSUMOTO Y,MIYAZATO M,YOKOYAMA H,et al.Role of M2 and M3 muscarinic acetylcholine receptor subtypes in activation of bladder afferent pathways in spinal cord injured rats[J].Urology,2012,79(5).DOI:10.1016/j.urology.2012.01.022.