中华妇产科杂志
中華婦產科雜誌
중화부산과잡지
CHINESE JOUNAL OF OBSTETRICS AND GYNECOLOGY
2008年
5期
341-345
,共5页
蒋芳%郎景和%朱兰%陈杰%刘键平
蔣芳%郎景和%硃蘭%陳傑%劉鍵平
장방%랑경화%주란%진걸%류건평
子宫脱垂%神经肽Y%受体,神经肽Y%子宫附件
子宮脫垂%神經肽Y%受體,神經肽Y%子宮附件
자궁탈수%신경태Y%수체,신경태Y%자궁부건
Uterine prolapse%Neuropeptide Y%Receptors,neuropeptide Y%Adnexa uteri
目的 研究神经肽Y(NPY)及其受体NPY-Y1、Y2在盆腔器官脱垂(POP)患者主韧带和宫骶韧带上的分布、表达及意义.方法 选择POP患者16例,按盆腔器官脱垂定量(POP-Q)分度法分度,其中POP-Q分度法为Ⅰ、Ⅱ度者6例为A组,Ⅲ、Ⅳ度者10例为B组.选择无POP的卵巢非功能性肿瘤患者8例作为对照组.标本取自主韧带、宫骶韧带,经甲醛固定、石蜡包埋后切片,采用免疫组化法检测NPY的分布;采用RT-PCR技术检测NPY-Y1和Y2 mRNA的表达.结果 (1)NPY在主韧带、宫骶韧带上均有分布.与对照组比较,NPY在POP患者的主韧带和宫骶韧带上的分布有减少的趋势,但3组间比较,差异均无统计学意义(P＞0.05);NPY在各组患者自身主韧带和宫骶韧带上的分布情况比较,差异均无统计学意义(P＞0.05).(2)NPY-Y1和Y2 mRNA在主韧带、宫骶韧带中均有表达,并检测到NPY-Y1中97 bp的剪切变异体存在.(3)NPY-Y1 mRNA在主韧带上的表达,A组(3.9±1.0)与B组(6.0±1.5)之间,以及B组与对照组(3.4±0.9)之间比较,差异均有统计学意义(P=0.019,P=0.004);A组与对照组之间比较,差异无统计学意义(P=0.082).NPY-Y1 mRNA在宫骶韧带上的表达,A组(6.0±1.1)与B组(6.3±0.7)之间,以及A组与对照组(4.8±0.7)之间分别比较,差异均无统计学意义(P=0.151,P=0.690);B组与对照之间比较,差异有统计学意义(P=0.016).(4)NPY-Y2 mRNA在主韧带和宫骶韧带上的表达,A组(分别为0.56±0.21、0.67±0.13)、B组(分别为0.85±0.43、0.69±0.21)、对照组(分别为0.49±0.34、0.61±0.15)3组之间分别比较,差异均无统计学意义(P＞0.05).(5)NPY-Y1、Y2 mRNA在各组患者自身主韧带与宫骶韧带上的表达比较,差异均无统计学意义(P=0.084,P=0.470).结论 NPY及其受体在子宫主韧带及宫骶韧带上均有表达;NPY-Y1在主韧带及宫骶韧带上的表达水平显著升高,可能与局部血流减少、主要支持组织结构改变相关.
目的 研究神經肽Y(NPY)及其受體NPY-Y1、Y2在盆腔器官脫垂(POP)患者主韌帶和宮骶韌帶上的分佈、錶達及意義.方法 選擇POP患者16例,按盆腔器官脫垂定量(POP-Q)分度法分度,其中POP-Q分度法為Ⅰ、Ⅱ度者6例為A組,Ⅲ、Ⅳ度者10例為B組.選擇無POP的卵巢非功能性腫瘤患者8例作為對照組.標本取自主韌帶、宮骶韌帶,經甲醛固定、石蠟包埋後切片,採用免疫組化法檢測NPY的分佈;採用RT-PCR技術檢測NPY-Y1和Y2 mRNA的錶達.結果 (1)NPY在主韌帶、宮骶韌帶上均有分佈.與對照組比較,NPY在POP患者的主韌帶和宮骶韌帶上的分佈有減少的趨勢,但3組間比較,差異均無統計學意義(P＞0.05);NPY在各組患者自身主韌帶和宮骶韌帶上的分佈情況比較,差異均無統計學意義(P＞0.05).(2)NPY-Y1和Y2 mRNA在主韌帶、宮骶韌帶中均有錶達,併檢測到NPY-Y1中97 bp的剪切變異體存在.(3)NPY-Y1 mRNA在主韌帶上的錶達,A組(3.9±1.0)與B組(6.0±1.5)之間,以及B組與對照組(3.4±0.9)之間比較,差異均有統計學意義(P=0.019,P=0.004);A組與對照組之間比較,差異無統計學意義(P=0.082).NPY-Y1 mRNA在宮骶韌帶上的錶達,A組(6.0±1.1)與B組(6.3±0.7)之間,以及A組與對照組(4.8±0.7)之間分彆比較,差異均無統計學意義(P=0.151,P=0.690);B組與對照之間比較,差異有統計學意義(P=0.016).(4)NPY-Y2 mRNA在主韌帶和宮骶韌帶上的錶達,A組(分彆為0.56±0.21、0.67±0.13)、B組(分彆為0.85±0.43、0.69±0.21)、對照組(分彆為0.49±0.34、0.61±0.15)3組之間分彆比較,差異均無統計學意義(P＞0.05).(5)NPY-Y1、Y2 mRNA在各組患者自身主韌帶與宮骶韌帶上的錶達比較,差異均無統計學意義(P=0.084,P=0.470).結論 NPY及其受體在子宮主韌帶及宮骶韌帶上均有錶達;NPY-Y1在主韌帶及宮骶韌帶上的錶達水平顯著升高,可能與跼部血流減少、主要支持組織結構改變相關.
목적 연구신경태Y(NPY)급기수체NPY-Y1、Y2재분강기관탈수(POP)환자주인대화궁저인대상적분포、표체급의의.방법 선택POP환자16례,안분강기관탈수정량(POP-Q)분도법분도,기중POP-Q분도법위Ⅰ、Ⅱ도자6례위A조,Ⅲ、Ⅳ도자10례위B조.선택무POP적란소비공능성종류환자8례작위대조조.표본취자주인대、궁저인대,경갑철고정、석사포매후절편,채용면역조화법검측NPY적분포;채용RT-PCR기술검측NPY-Y1화Y2 mRNA적표체.결과 (1)NPY재주인대、궁저인대상균유분포.여대조조비교,NPY재POP환자적주인대화궁저인대상적분포유감소적추세,단3조간비교,차이균무통계학의의(P＞0.05);NPY재각조환자자신주인대화궁저인대상적분포정황비교,차이균무통계학의의(P＞0.05).(2)NPY-Y1화Y2 mRNA재주인대、궁저인대중균유표체,병검측도NPY-Y1중97 bp적전절변이체존재.(3)NPY-Y1 mRNA재주인대상적표체,A조(3.9±1.0)여B조(6.0±1.5)지간,이급B조여대조조(3.4±0.9)지간비교,차이균유통계학의의(P=0.019,P=0.004);A조여대조조지간비교,차이무통계학의의(P=0.082).NPY-Y1 mRNA재궁저인대상적표체,A조(6.0±1.1)여B조(6.3±0.7)지간,이급A조여대조조(4.8±0.7)지간분별비교,차이균무통계학의의(P=0.151,P=0.690);B조여대조지간비교,차이유통계학의의(P=0.016).(4)NPY-Y2 mRNA재주인대화궁저인대상적표체,A조(분별위0.56±0.21、0.67±0.13)、B조(분별위0.85±0.43、0.69±0.21)、대조조(분별위0.49±0.34、0.61±0.15)3조지간분별비교,차이균무통계학의의(P＞0.05).(5)NPY-Y1、Y2 mRNA재각조환자자신주인대여궁저인대상적표체비교,차이균무통계학의의(P=0.084,P=0.470).결론 NPY급기수체재자궁주인대급궁저인대상균유표체;NPY-Y1재주인대급궁저인대상적표체수평현저승고,가능여국부혈류감소、주요지지조직결구개변상관.
Objective To evaluate the distribution of neuropeptide Y and its receptors in the cardinal ligament and uterosaeral ligaments in women with and without pelvic organ prolapse(POP).Methods Sixteen patients with pelvic organ prolapse entered the study.All patients were evaluated by pelvic organ prolapse quantitation(POP-Q).Group A consisted of six patients with grade Ⅰ,Ⅱ POP,and group B comprised ten patients with grade Ⅲ,Ⅳ POP.Eight nonfunctional ovarian tumor patients without POP were recruited as control subjects.Biopsies of cardinal ligament and uterosacral ligament were obtained from each woman during surgery.Immunohistochemical study with polyclonal antibody against a general nerve marker S-100 and neuropeptide Y was performed on paraffin-embedded sections of all the samples.In addition,mRNA levels of the human NPY-Y1 and NPY-Y2 receptors were assessed in both patients and controls.Results (1)NPY immunoreactivities were identified in both cardinal ligament and uterosacral ligament. NPY immunoreactive nerve fibers were insignificantly lower in POP patients(P＞0.05).The distribution pattern of NPY was similar in cardinal ligament and uterosacral ligament ( P＞0. 05 ). (2)mRNAs encoding the NPY-Y1 and NPY-Y2 receptors were detected in the pelvic supporting tissues. Besides the expected NPY-Y1 PCR products, an additional 97 bp long amplicon originating from an alternative splicing event was found in most tissues studied. (3)In cardinal ligaments, mRNA encoding NPY-Y1 receptor had a significant difference between group A(3.9±1.0)and B (6. 0±1.5), and between control (3.4±0.9) and group B (P = 0. 019,P = 0. 004), while there was no significant difference between group A and controls(P =0. 082). In uteresacral ligaments, mRNA encoding NPY-Y1 receptor had no significant difference between Group A(6. 0±1.1) and B (6. 3±0. 7), or between group A and controls(4. 8±0. 7;P = 0. 151 ,P = 0. 690);while there was a significant difference between group B and controls (P = 0. 016).(4) mRNA encoding NPY-Y2 receptor had no significant difference between controls (0. 49±0. 34, 0. 61±0. 15 ), group A (0. 56±0. 21,0. 67±0. 13) and group B (0. 85±0. 43, 0. 69±0. 21 ) patients in cardinal ligament and uterosacral ligaments ( P＞0. 05 ). (5) mRNA encoding NPY-Y1 ( P = 0. 084 ) and NPY-Y2 (P=0.470) receptors had no significant difference between cardinal ligament and uterosacral ligament.Conclusions There are NPY and NPY receptors in cardinal and uterosacral ligaments. The increased expression of NPY Y1 receptor may be related to local blood flow reduction and structural changes of pelvic supporting tissue.
