天津医药

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间质性膀胱炎膀胱粘膜组织病理和超微病理的相关研究

张卫1,韩瑞发2   

  1. 1. 天津医大二院泌尿外科
    2. 天津市泌尿外科研究所
  • 收稿日期:2009-11-16 修回日期:2009-12-22 出版日期:2010-09-15 发布日期:2010-09-15
  • 通讯作者: 韩瑞发

  • Received:2009-11-16 Revised:2009-12-22 Published:2010-09-15 Online:2010-09-15

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摘要： 【摘要】目的　探讨间质性膀胱炎膀(Interstitial Cystitis, IC)胱粘膜上皮组织病理学与超微病理的改变与特征。方法 收集天津医科大学第二医院2006年3月-2007年12月住院的女性IC患者的膀胱粘膜标本16例和女性输尿管结石患者标本16例作为对照组。两组性别及年龄匹配。IC患者临床表现主要为尿频、尿急、膀胱充盈后疼痛及排尿后疼痛减轻，尿常规检查与中段尿普通细菌培养阴性，盆腔症状评分（PUF）均在15分以上，钾离子试验阳性，膀胱镜检查可见膀胱粘膜多发性球状出血点。符合1987年美国糖尿病、消化及肾病协会( NIDDK) 制定的IC 诊断标准。采用普通光镜和透射电镜的方法观察膀胱粘膜上皮和粘膜肥大细胞浸润及脱颗粒情况。结果　光镜下IC患者膀胱粘膜上皮发生断裂或缺失，粘膜有大量肥大细胞浸润，同正常对照组相比t=12.724（P<0.05）；电镜下IC患者膀胱粘膜伞状细胞发生缺失或者相邻伞状细胞间连接缺失，相邻细胞间隙增宽，IC患者肥大细胞大部分呈脱颗粒状态，同正常对照组相比χ2=18.762（P<0.05）。结论IC患者存在膀胱粘膜上皮尤其伞状细胞的形态改变和缺失是膀胱粘膜上皮通透性增加的重要原因，同时膀胱粘膜伴有肥大细胞的增多和激活，两者在IC的发病中有着重要的作用。

关键词: 间质性膀胱炎, 膀胱, 粘膜上皮, 肥大细胞

Abstract: 【Abstract】Objective To observe histopathological and ultramicropathological characteristics of bladder mucosa in interstitial cystitis（IC）patients.Methods Bladder mucosal specimens were harvested from 16 patients with IC and 16 normal controls. Two groups were match in sex and age. They were characterized by bladder pain, urinary frequency and pelvic pain associated with dyspareunia.They were negative in urinalysis and urine culture.They were diagnosised according to NIDDK criteria.All patients had PUF scores＞15, PST positive and Glomerulations in cystoscopy.Biopsy from two groups were observed through light microscope and transmission electron microscope. Results There are regions which appeare to be detached in IC patients' bladder mucosa through light microscope. There are many mast cells infiltrating in mucosa layer through light microscope in IC patients, there are significant difference between two groups(t=12.724, P＜0.05). There are regions between cells in which portions of adjacent umbrella cells appeare to be detached in IC patients' bladder mucosa. Mast cells in IC group manifestate degranulation in electron microscope, there are significant difference between two groups(χ2=18.762, P＜0.05). Conclusions There are regions between cells in which portions of adjacent umbrella cells appeare to be detached in IC patients' bladder mucosa to increased permeability of bladder mucosa, There are many mast cells infiltrating in mucosa layer through light microscope in IC patients。

Key words: Cystitis-interstitial, Bladder, Mucosa, Mast cells