尿液刺激在尿道术后瘢痕形成中的作用.doc

尿液刺激在尿道术后瘢痕形成中的作用 周庆余，卢根生，罗洋，张庆华 　(第三军医大学西南医院全军泌尿外科中心，重庆400038) 提　要： 目的　研究尿液刺激对尿道术后瘢痕形成的影响以及转化生长因子-β1 ( TGF-β1) 在其中的作用。方法　建立犬的尿道狭窄模型，分为对照组；无尿液刺激组；尿液刺激组。采集标本后用RT-PCR和western blot检测TGF-β1的表达情况，VanGieson染色检测瘢痕中胶原纤维变化情况。结果　所有尿道损伤组TGF-β1 mRNA和蛋白的表达均较对照组显著升高( P 0. 05)；损伤组中尿液刺激组TGF-β1 mRNA和蛋白的表达较无尿液刺激组显著升高( P 0. 05)；尿道损伤组胶原纤维含量均较对照组显著升高( P 0. 05)；而尿液刺激组胶原纤维含量较无尿液刺激组显著升高( P 0. 05)。结论　尿液刺激是尿道狭窄瘢痕形成的一个重要危险因素，它通过上调瘢痕组织TGF-β1水平得以促使狭窄加重。 关键词：尿液刺激；尿道瘢痕；转化生长因子β1； The role of continued urine in the formattion of scar tissue after urethral surgery ZHUO Qing-yu, LU Gen-sheng, LUO yang,ZHANG Qing-hua (Urinary Surgery Research Center, Southwest Hospital, Third Military Medical University, Chongqing 400038, China) Abstract: Objective To study effect of continued urine on the formattion of scar tissue after urethral surgery, and the role of transforming growth factor β1 (TGF-β1) in the process. Methods Experimental models of canine urethral stricture were established. Experimental grouping includes control group, injury group without continued urine stimulate and injury group with continued urine stimulate. The expression of TGF-β1 mRNA and protein were measured by RT-PCR and western blot respectively. Collagen fibers were observed by VanGieson staining. Results The expression of TGF-β1 and the content of collagen fibers were significantly increased in injury groups than in control group(P 0. 05). Meanwhile, The expression of TGF-β1 and the content of collagen fibers were significantly increased in injury groups with continued urine stimulate than in injury group without continued urine stimulate (P 0. 05). Conclusion Continued urine stimulates the formation of scar tissue after urethral surgery, and TGF-β1 has a key role in the process. Key words: continued urine; urethral scar tissue; transforming growth factor β1 尿道狭窄是泌尿外科的常见病，其病理学改变是创面过度修复，产生增生性瘢痕，进而破坏尿道完整性，造成功能障碍，临床治疗是一大难题，分外伤性和炎症性两种[1]。传统治疗方法有尿道狭窄内切开、狭窄段尿道切除并吻合及尿道替代治疗等。但由于术后远期效果不确定及狭窄复发率高，寻找更有效的治疗手段十分必要。目前较多的研究来探讨尿道狭窄形成的分子机制，指出