中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2013年
7期
500-503
,共4页
盆腔脏器脱垂%尿失禁,压力性%胶原%血管活性肠肽
盆腔髒器脫垂%尿失禁,壓力性%膠原%血管活性腸肽
분강장기탈수%뇨실금,압력성%효원%혈관활성장태
Pelvic organ prolapse%Urinary incontinence,stress%Collagen%Vasoactive intestinal peptide
目的 探讨女性盆底功能障碍性疾病(POP)及压力性尿失禁(SUI)与盆底胶原含量、结构以及血管活性肠肽(VIP)表达的关系,分析胶原与POP疾病发生的关系.方法 对象为2009年3月至2011年3月于吉林大学第二医院妇科行经腹或经阴道子宫全切患者,共90例.将90例患者分对照组(无POP及SUI)30例、POP组30例及POP合并SUI组30例,取主韧带、宫骶韧带及尿道旁标本,光镜及电镜观察其组织学特点,测量胶原原纤维直径,免疫组化染色测定胶原含量以及VIP的表达.结果 (1)POP组及POP合并SUI组平滑肌束弥漫性萎缩；成纤维细胞代谢活跃.(2)POP组及POP合并SUI组胶原原纤维直径明显大于对照组(P＜0.01),Ⅰ、Ⅲ型胶原表达显著降低(P＜0.01),VIP的表达明显降低(P＜0.05).结论 SUI和POP患者盆底胶原含量及超微结构的改变可能与POP及SUI的发生发展有关.VIP递质在宫骶韧带、主韧带中含量的减少与POP密切相关,提示神经损伤在PFD中起重要作用.
目的 探討女性盆底功能障礙性疾病(POP)及壓力性尿失禁(SUI)與盆底膠原含量、結構以及血管活性腸肽(VIP)錶達的關繫,分析膠原與POP疾病髮生的關繫.方法 對象為2009年3月至2011年3月于吉林大學第二醫院婦科行經腹或經陰道子宮全切患者,共90例.將90例患者分對照組(無POP及SUI)30例、POP組30例及POP閤併SUI組30例,取主韌帶、宮骶韌帶及尿道徬標本,光鏡及電鏡觀察其組織學特點,測量膠原原纖維直徑,免疫組化染色測定膠原含量以及VIP的錶達.結果 (1)POP組及POP閤併SUI組平滑肌束瀰漫性萎縮；成纖維細胞代謝活躍.(2)POP組及POP閤併SUI組膠原原纖維直徑明顯大于對照組(P＜0.01),Ⅰ、Ⅲ型膠原錶達顯著降低(P＜0.01),VIP的錶達明顯降低(P＜0.05).結論 SUI和POP患者盆底膠原含量及超微結構的改變可能與POP及SUI的髮生髮展有關.VIP遞質在宮骶韌帶、主韌帶中含量的減少與POP密切相關,提示神經損傷在PFD中起重要作用.
목적 탐토녀성분저공능장애성질병(POP)급압력성뇨실금(SUI)여분저효원함량、결구이급혈관활성장태(VIP)표체적관계,분석효원여POP질병발생적관계.방법 대상위2009년3월지2011년3월우길림대학제이의원부과행경복혹경음도자궁전절환자,공90례.장90례환자분대조조(무POP급SUI)30례、POP조30례급POP합병SUI조30례,취주인대、궁저인대급뇨도방표본,광경급전경관찰기조직학특점,측량효원원섬유직경,면역조화염색측정효원함량이급VIP적표체.결과 (1)POP조급POP합병SUI조평활기속미만성위축；성섬유세포대사활약.(2)POP조급POP합병SUI조효원원섬유직경명현대우대조조(P＜0.01),Ⅰ、Ⅲ형효원표체현저강저(P＜0.01),VIP적표체명현강저(P＜0.05).결론 SUI화POP환자분저효원함량급초미결구적개변가능여POP급SUI적발생발전유관.VIP체질재궁저인대、주인대중함량적감소여POP밀절상관,제시신경손상재PFD중기중요작용.
Objective To explore the alteration of collagen ultrastructure and content in uterine ligaments and paraurethral tissue and explore whether the alteration may contribute to stress urinary incontinence (SUI) and pelvic organ prolapse (POP).Methods The cardinal ligament,uterosacral ligament and paraurethral tissue samples were obtained from 90 subjects undergoing hysterectomy.Collagen ultrastructure was examined with transmission electron microscopy.And collagen content and expression of vasoactive intestinal peptide (VIP) were examined with immunohistochemisty.Results The smooth muscle fascicles were thinner in the patients of SUI and POP.Arrangement of smooth muscle fascicles was disorderly.Fiheroblast was metabolically active.The mean collagen fibril diameters in the SUI and POP groups were larger than that in the control group (P ＜0.01).The mean contents of collagen Ⅰ and Ⅲ in the SUI and POP groups were lower than that in the control group (P ＜ 0.01).The expression of VIP was lower (P ＜ 0.05).Conclusion Predominance of collagen degradation during tissue repair may contribute to and promote POP and SUI.The decrease of VIP might be related with nerve damage or degeneration to cause or accelerate the progress of pelvic organ prolapse.
