간질성방광염에서 비만세포 수의 진단적 유용성
The Diagnostic Value of Mast Cell Count in Interstitial Cystitis
소속 상세정보
최만석/Man Seok Choi
김수일/정세일/정경우/권헌영/Soo ll Kim/Se ll Jung/Gyung Woo Jung/Heon Young Kwon
KMID : 0358319980390101021
Abstract
서론
간질성방광염이란 대개 중년부인에서 나타나며 하복부동통, 골반통, 빈뇨 및 급뇨 등의 증
상과 무균뇨를 특징으로 하는 만성적 증상군을 말한다. 간질성방광염은 점진적으로 시작되
며 서서히 진행되기 때문에 초기에 여성에서는 만성세균성방광염, 남성에서는 전립선염으로
오진이 되기도 한다. 1907년 Nite가 간질성방광염을 명명한 후 많은 발병론과 병인이 가설
로 제시되었으나 정확한 병인과 발병에 대해서는 아직까지 정의되지 않았으나 자가면역질환
설, 감염설, 혈관질환설 등의 가설이 제시되고 있다. 간질성방광염의 해부병리학적 특징으로
점막하 특히 근층내의 비만세포의 수적 증가가 보고되었으며 또한 동반된 다른 임상증상으
로 50% 이상의 환자군에서 약물 및 음식에 대한 알러지 증상을 나타낸다. Larsen 등은 간
질성방광염에서 비만세포의 수를 측정하여 간질성방광염의 진단적 특징이라고 제시하였다.
본 연구자는 Parson 기준에 의하여 간질성방광염으로 진단된 16례에서 방광경하 조직생검
을 실시한 후 방광비만세포수를 측정하여 간질성 방광염에서 진단적 유용성을 평가하고자
주증상과 비만세포지수와의 상관관계를 비교 분석하였으며, 만성방광염환자에서와 비만세포
지수를 비교하였다.
#초록#
Purpose : In this study we attempted to find the value of mast cell index as a
diagnostic purpose of the interstitial cystitis (IC)
Materials and Methods : We compared clinical symptoms and the mast cell index in
the IC and chronic cystitis patients. 16 cases of the IC patients, determined by Parson's
criteria, were monitored. Under the spinal anesthesia and bladder overdistension with
pressure of 60-80㎝H2O, bladder wall was checked under cystoscopy. The
biopsies of the bladder mucosa and detrusor muscle were obtained. The mast cell index
was estimated under light microscope(x400 magnification) after it was stained with
toluidine blue.
Results : In the IC patients, there was significant correlation between the bladder
capacity and mast cell index(p<0.01). Seven patients with 100-199㎖ bladder capacity
range had mast cell index of 62.94±3.66, and 8 patients in 200-299㎖ range had 44.78±
9.12 mast cell index. In relation between the frequency of nocturia and mast cell index,
frequency of 1-2 nocturia patients had mast cell index of 53.75±11.45(8 cases), 3-4
nocturia had 44.82±8.42(5 cases), 4 or more nocturia had 60.13± 17.94 mast cell index(3
cases). 10 patients with urgency had 46.41±10.29 mast cell index, while 6 patients with
no urgency problem had 61.73±9.92. 9 patients with lower abdominal pain had mast cell
index of 51.37±11.79, while 7 patients with lower abdominal pain had 53.16±11.79. In
comparison between the IC and chronic cystitis, there was significant difference between
them. In IC, mast cell index was 52.09±12.49 and in chronic cystitis, mast cell index
was 23.51±7.10(p<0.01).
Conclusions : In this study, the results were showed that there is no direct correlation
of mast cell index with nocturia, urgency and lower abdominal pain in IC patients,
however there is inverse relationship between mast cell index and the bladder capacity,
and we also found significant mast cell index differences between the IC and chronic
cystitis. Therefore, we suggest that mast cell index is one of the pathological
characteristics of IC and useful method to diagnose the interstitial cystitis.
키워드
Interstitial cystitis; Mast cell index;
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