女性膀胱过度活动症患者尿液中脑源性神经营养因子的表达及意义
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摘要
目的:探讨女性膀胱过度活动症(overactive bladder,OAB)患者尿液中脑源性神经营养因子(brain-derived neurotrophic factor,BDNF)的表达水平及其临床意义。方法:按照纳入标准及排除标准入选女性OAB患者40例,选择女性健康志愿者30例作为对照组,分别在膀胱充盈时收集其尿液,尿液中BDNF的表达采用ELISA法进行检测,结果用每个尿液标本的肌酐值(Cr)来标准化BDNF/Cr(pg/mg)。结果:OAB组尿液中BDNF/Cr的浓度(892.1±420.7)pg/mg明显高于对照组(150.6±63.5)pg/mg,差异比较有统计学意义(P<0.05)。轻、中、重度OAB患者尿液BDNF/Cr分别是(560.2±274.5) pg/mg、(825.3±402.6) pg/mg和(1148.5±510.2) pg/mg,两两比较,差异有统计学意义(P<0.05)。40例女性OAB患者尿液BDNF/Cr与膀胱过度活动症状评分(OABSS)呈正相关(r=0.619,P<0.01),差异有统计学意义。结论:女性膀胱过度活动症患者的尿液BDNF表达水平比健康人群明显高,且与膀胱过度活动症状严重程度呈正相关性,BDNF有可能成为女性OAB的诊断标记物。
Objective:To investigate the expression and significance of urinary brain-derived neurotrophic factor(BDNF)in female patients with overactive bladder(OAB).Methods:A total of 40 female patients with overactive bladder were enrolled in this study,30 normal women were selected as control group.Urine was collected during bladder filling,respectively.The expression of BDNF in urine was detected by ELISA.Results The creatinine value(Cr) of each urine sample was used to standardize the expression of BDNF/Cr(pg/mg).Results:The urinary BDNF/Cr 1 evels of the control group were(150.6±63.5) pg/mg,and the urinary BDNF/Cr levels of the female patients were(892.1±420.7) pg/mg.There were statistical differences between two groups(P<0.05).The urinary BDNF/Cr levels in the patients with mild,moderate and severe OAB were(560.2±274.5)pg/mg,(825.3±402.6)pg/mg and(1 148.5±510.2)pg/mg,respectively,there was significant difference between the two groups(P<0.05).There was a correlation between the urinary BDNF/Cr levels and the severity of OABSS,the difference was statistically significant(r=0.619,P<0.01).Conclusion:The urinary BDNF levels of the female patients with overactive bladder are significantly higher compared with normal women and correlated with the severity of OABSS.BDNF can be regarded as a objective diagnosis biomarker of OAB.
Objective:To investigate the expression and significance of urinary brain-derived neurotrophic factor(BDNF)in female patients with overactive bladder(OAB).Methods:A total of 40 female patients with overactive bladder were enrolled in this study,30 normal women were selected as control group.Urine was collected during bladder filling,respectively.The expression of BDNF in urine was detected by ELISA.Results The creatinine value(Cr) of each urine sample was used to standardize the expression of BDNF/Cr(pg/mg).Results:The urinary BDNF/Cr 1 evels of the control group were(150.6±63.5) pg/mg,and the urinary BDNF/Cr levels of the female patients were(892.1±420.7) pg/mg.There were statistical differences between two groups(P<0.05).The urinary BDNF/Cr levels in the patients with mild,moderate and severe OAB were(560.2±274.5)pg/mg,(825.3±402.6)pg/mg and(1 148.5±510.2)pg/mg,respectively,there was significant difference between the two groups(P<0.05).There was a correlation between the urinary BDNF/Cr levels and the severity of OABSS,the difference was statistically significant(r=0.619,P<0.01).Conclusion:The urinary BDNF levels of the female patients with overactive bladder are significantly higher compared with normal women and correlated with the severity of OABSS.BDNF can be regarded as a objective diagnosis biomarker of OAB.
引文
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[12] Antunes-Lopes T,Pinto R,Barros SC,et al.Urinary Neurotrophic Factors in Healthy Individuals and Patients with Overactive Bladder[J].The Journal of Urology,2013,189(1):359-365.
[13] Antunes-Lopes T.Urinary levels of brain derived neurotrophic factor (BDNF) in women with overactive bladder(OAB) syndrome correlate with the severity of symptoms[J].J Eur Urology,2011,10(2):277-278.
[14] 胡浩,许克新,张晓鹏,等.伴有膀胱过度活动症症状的前列腺增生患者尿液中脑源性神经营养因子的表达[J].北京大学学报(医学版),2014,46,(4):519-523.
[15] Wang LW,Han XM,Chen CH,et al.Urinary brain-derived neurotrophic factor:a potential biomarker for objective diagnosis of overactive bladder[J].Int Urol Nephrol,2014,46(2):341-347.
[2] 那彦群.中国泌尿外科疾病诊断治疗指南[M].2014版.北京:人民卫生出版社,2013:330-335.
[3] Oddiah D,Anand P,Mcmahon SB,et al.Rapid increase of NGF,BDNF and NT-3 mRNAs in inflamed bladder[J].Neuroreport,1998,9(7):1455-1458.
[4] Bhide AA,Cartwright R,Khullar V,et al.Biomarkers in overactive bladder[J].Int Urogynecol J,2013,24(7):1065-1072.
[5] Gormley EA,Lightner DJ,Faraday M,et al.Diagnosis and treatment of overactive bladder (non-neurogenic) in adults:AUA/SUFU guideline amendment[J].J Urol.2015,193(5):1572-1580.
[6] 李向哲,王灿,吴勤峰,等.脊髓损伤后脑源性神经营养因子神经生物学效应的研究进展[J].中国康复理论与实践,2018,24(2):160-164.
[7] 杨江华,薛建.神经营养因子与膀胱过度活动症[J].北京医学,2013,35(1):40-42.
[8] Pinto R,Frias B,Allen S,et al.Sequestration of brain derived nerve factor by intravenous delivery of TrkB—Ig2 reduces bladder overactivity and noxious input in animals with chronic cystitis [J].Neuroscience,2010,166(3):907-916.
[9] Jiang YH,Liu HT,Kuo HC.Decrease of Urinary Nerve Growth Factor but Not Brain-Derived Neurotrophic Factor in Patients with Interstitial Cystitis/Bladder Pain Syndrome Treated with Hyaluronic Acid[J].PLOS One,2014,9(3):e91609.
[10] Pinto R,Lopes T,Frias B,et al.Trigonal injection of botulinum toxin A in patients with refractory bladder pain syndrome/interstitial cystitis[J].European Urology,2010,58(3):360-365.
[11] Qiao LY,Vizzard MA.Cystitis-induced upregulation of tyrosine kinase(TrkA,TrkB)receptor expression and phosphorylation in rat micturition pathways[J].J Comp Neurol,2002,454(2):200-211.
[12] Antunes-Lopes T,Pinto R,Barros SC,et al.Urinary Neurotrophic Factors in Healthy Individuals and Patients with Overactive Bladder[J].The Journal of Urology,2013,189(1):359-365.
[13] Antunes-Lopes T.Urinary levels of brain derived neurotrophic factor (BDNF) in women with overactive bladder(OAB) syndrome correlate with the severity of symptoms[J].J Eur Urology,2011,10(2):277-278.
[14] 胡浩,许克新,张晓鹏,等.伴有膀胱过度活动症症状的前列腺增生患者尿液中脑源性神经营养因子的表达[J].北京大学学报(医学版),2014,46,(4):519-523.
[15] Wang LW,Han XM,Chen CH,et al.Urinary brain-derived neurotrophic factor:a potential biomarker for objective diagnosis of overactive bladder[J].Int Urol Nephrol,2014,46(2):341-347.