伴有膀胱过度活动症症状的良性前列腺增生患者尿液中脑源性神经营养因子的表达

摘要/Abstract

摘要： 目的：探讨伴有膀胱过度活动症（overactive bladder，OAB）症状的良性前列腺增生患者尿液中脑源性神经营养因子（brainderived neurotrophic factor，BDNF）的表达水平，以及其与OAB症状严重程度的相关性。方法：根据纳入标准和排除标准共纳入178例拟行经尿道前列腺电切术的良性前列腺增生患者，行常规术前检查及尿动力学检查，采用国际前列腺症状评分表和OAB症状评分表进行症状评估，采用ELISA方法检测患者尿液BDNF表达水平，结果用尿液标本的肌酐（Cr）值进行标准化BDNF/Cr（mg/mol）。结果：中度和重度下尿路症状患者尿液BDNF/Cr平均值分别为(1.189±0.753) mg/mol和(1.817±1.110) mg/mol (P<0.001)。梗阻Ⅲ~Ⅵ级患者尿液BDNF/Cr平均值分别为(1.382±0.945) mg/mol、(1.435±0.938) mg/mol、(1.640±1.104) mg/mol和(1.653±1.019) mg/mol (P>0.05)，BDNF/Cr值与梗阻的严重程度无显著的相关关系（r=0.103，P=0.173）。不伴OAB症状和伴OAB症状患者的尿液BDNF/Cr平均值分别为(0.297±0.183) mg/mol和(1.913±0.843) mg/mol (P<0.001)。轻度、中度和重度OAB症状患者的尿液BDNF/Cr平均值分别为(1.501±0.543) mg/mol、(1.806±0.703) mg/mol和(2.560±0.979) mg/mol (P<0.05)，尿液BDNF/Cr值与OAB症状的严重程度呈显著的相关关系（r=0.743，P<0.001）。不伴逼尿肌过度活动症状和伴逼尿肌过度活动症状患者的尿液BDNF/Cr平均值分别为(1.194±1.013) mg/mol和(1.917±0.866) mg/mol (P<0.001)。结论：中度和重度下尿路症状的良性前列腺增生患者尿液中BDNF表达水平与梗阻程度没有明显相关性；与不伴有OAB症状的良性前列腺增生患者相比，伴有OAB症状的患者尿液中BDNF的表达水平会明显升高，且与OAB症状的严重程度相关。

关键词: 脑源性神经营养因子, 前列腺增生, 膀胱, 过度活动性

Abstract: Objective：To investigate the expression of urinary brainderived neurotrophic factor (BDNF) in benign prostatic hyperplasia patients with overactive bladder (OAB) symptoms and its correlation with the severity of OAB symptoms. Methods: According to the inclusion and exclusion criteria, a total of 178 patients with benign prostatic hyperplasia who were to undergo transurethral resection of prostate (TURP) were enrolled in this study. All the patients had accepted basic preoperative evaluations, as well as an assessment of their International Prostate Symptom Score (IPSS) and Overactive Bladder Symptom Score (OABSS). The patients who had been scheduled for surgery had to take the urodynamic assessment. Urinary BDNF levels were measured by the enzymelinked immunosorbent assay (ELISA) and the results were further normalized to the concentration of urinary creatinine (BDNF/Cr, mg/mol). Results: The urinary BDNF/Cr levels of the patients with moderate and severe lower urinary tract symptoms were (1.189±0.753) mg/mol and (1.817±1.110) mg/mol (P<0.001). The urinary BDNF/Cr levels of the patients with grades Ⅲ-Ⅵ obstruction were (1.382±0.945) mg/mol, (1.435±0.938) mg/mol, (1.640±1.104) mg/mol, and (1.653±1.019) mg/mol, respectively (P>0.05). There was no correlation between the urinary BDNF/Cr levels and the severity of obstruction (r=0.103, P=0.173). The urinary BDNF/Cr levels in the patients with and without OAB symptoms were (1.913±0.843) mg/mol and (0.297±0.183) mg/mol (P<0.001). The urinary BDNF/Cr levels in the patients with mild, moderate and severe OAB symptoms were (1.501±0.543) mg/mol, (1.806±0.703) mg/mol and (2.560±0.979) mg/mol, respectively (P<0.05). There was a correlation between the urinary BDNF/Cr levels and the severity of OAB symptoms (r=0.743, P<0.001). The urinary BDNF/Cr levels in the patients with urodynamic detrusor overativity were significantly higher than those without detrusor overativity ［(1.917±0.866) mg/mol and (1.194±1.013) mg/mol, P<0.001］. Conclusion: There is no correlation between urinary BDNF and severity of obstruction in benign prostatic hyperplasia patients with moderate and severe lower urinary tract symptoms. The urinary BDNF levels in patients with OAB symptoms are elevated compared with patients without OAB symptoms, and are correlated with the severity of OAB symptoms.

Key words: Brain-derived neurotrophic factor, Prostatic hyperplasia, Urinary bladder, overactive

胡浩, 许克新, 张晓鹏, 方志伟, 陈京文, 霍飞, 王栋, 王晓峰. 伴有膀胱过度活动症症状的良性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.

HU Hao, XU Ke-Xin, ZHANG Xiao-Peng, FANG Zhi-Wei, CHEN Jing-Wen, HUO Fei, WANG Dong, WANG Xiao-Feng. Expression of brainderived neurotrophic factor in urine of patients with benign prostatic hyperplasia complicated overactive bladder symptoms[J]. Journal of Peking University(Health Sciences), 2014, 46(4): 519-523.

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