绝经后压力性尿失禁患者盆底支持结构雌激素受体的研究  

Study on estrogen receptor around levator ani muscle for female stress urinary incontinence

作　　者：朱兰[1] 郎景和[1] 冯瑞娥[2] 陈杰[2] 

机构地区：[1]中国医学科学院中国协和医科大学北京协和医院妇产科,100730 [2]中国医学科学院中国协和医科大学北京协和医院病理科,100730

出　　处：《中华妇产科杂志》2004年第10期655-657,共3页Chinese Journal of Obstetrics and Gynecology

基　　金：国家自然科学基金资助项目(30170975)

摘　　要：目的探讨绝经后压力性尿失禁(SUI)患者盆底支持结构雌激素受体(ER)与SUI发生的关系。方法采用免疫组化方法,测定14例SUI患者(SUI组)、7例盆底器官膨出(POP)患者(POP组)肛提肌及其周围组织中ER阳性率,并选择同期10例非卵巢功能性肿瘤和宫颈病变患者作为对照(对照组)。结果3组患者肛提肌及其周围组织中,ER阳性率均不高,仅为67%。ER细胞核染色阳性的细胞为平滑肌细胞、结缔组织细胞及小神经细胞。肛提肌及其周围组织中,SUI组的结缔组织、平滑肌及小神经细胞的ER阳性率分别为11%、28%、27%,POP组分别为41%、95%、116%,对照组分别为14%、47%、57%。SUI组与对照组比较,差异有极显著性(P<001);SUI组与POP组比较,差异也有极显著性(P<001)。结论绝经后SUI患者的盆底支持结构的退行性病变与雌激素受体水平低下有关;提示POP患者的肛提肌及其周围组织的ER减少,易发生SUI。Objective To explore the relationship between estrogen receptor and the occurrence of stress urinary incontinence (SUI) through analysis on estrogen receptor (ER) around levator ani muscle Methods The biopsy specimens around levator ani muscle were obtained from 31 subjects undergoing total vaginal hysterectomy (TVH), laparoscopic assistant hysterectomy (LAVH) and tension free vaginal tape (TVT) procedures, who were assigned in to control, pelvic organ prolapse (POP) and SUI groups The histological structures around levator ani muscle were examined with routine HE staining ER in structures around levator ani muscle was evaluated by immunohistochemical staining Results ER positive staining rate in levator ani muscle and surrounding tissues was 6 7% among total samples ER positive staining located in nuclei of connective tissue, smooth muscle and small nerve cells The positive rate in connective tissue, smooth muscle and small nerve cells was 1 4%, 4 7%,5 7% in control group, 1 1%, 2 8%,2 7% in SUI group and 4 1%, 9 5%,11 6% in POP group, respectively It was significantly lower in SUI group than that in control group ( P <0 01), and POP group ( P <0 01) Conclusions There is close relationship between degeneration of pelvic support construction and deficiency in ER around levator ani muscle ER positive staining in SUI group was significantly lower than that in POP group, suggesting that decrease of ER around levator ani muscle in POP might lead to the occurrence of SUI

关 键 词：患者 SUI ER 盆底 肛提肌 周围组织 雌激素受体 细胞核 器官 神经细胞 

分 类 号：R694[医药卫生—泌尿科学]