女性盆底功能障碍疾病患者肛提肌超微结构研究  

Levator Ani Muscle Ultrastructure in Patients with Stress Urinary Incontinence and Pelvic Prolapse Organ

作　　者：李玉芳[1] 郭端英[1] 魏萍[1] 

机构地区：[1]深圳市龙岗中心医院妇产科,深圳市518116

出　　处：《医药论坛杂志》2008年第12期15-16,18,共3页Journal of Medical Forum

摘　　要：目的通过透射电镜观察肛提肌的超微结构,同时测量肛提肌肌纤维直径,探讨SUI和POP的发病机制。方法选取深圳市龙岗中心医院妇科2006年6月至2007年6月确诊为SUI和POP行阴式手术的10例患者为实验组,及同期因子宫良性病变行阴式子宫切除术的10例患者为对照组。术中取肛提肌标本,通过透射电镜观察肛提肌超微结构的变化,并测量肛提肌肌纤维直径。结果①SUI和POP患者肛提肌:肌纤维密度相对降低;肌细胞内线粒体肿胀,肌质网扩张;间质细胞增生明显,胶原纤维量增多;可见代谢活跃的成纤维细胞及肌纤维细胞;可见破纤维细胞;局部有变性坏死区,周围有新生的胶原纤维。②实验组肛提肌肌纤维直径为(53.68±10.96)μm,小于对照组的(64.72±9.44)μm,差异有显著性(P<0.05)。结论SUI和POP患者肛提肌萎缩及纤维化,造成了盆底功能障碍。Objective The morphology of levator ani muscle was examined by transmission electron microscope, and the muscle fiber diameters of levator ani muscle was also measured. To explore whether the alteration can contribute to SUI and POP. Methods Total 10 cases of biopsy specimens in SUI and POP women who received total vaginal hysterectomy （TVH）and anterior and posterior colporrhaphy from July 2006 to July 2007 were enrolled as study group. Another 10 cases of biopsy specimens in the women were selected as control group who received TVH suffered from benign conditions. No evidence of SUI and POP was found in control group. The morphology of levator ani muscle examined by transmission electron microscope, and the muscle fiber diameters of levator ani muscle measured were compared between two groups. Results ①The muscular fiber density of levator ani muscles in SUI and POP groups was decreased. Mitochondria and RER occur swelling in muscular cell. It is obvious that interstitial cell hyperplasia and collagen fibers. The areas destroyed are repaired by renewal collagen, in which also found collagenoblasts, myofibroblasts and fibroclasts. ②The mean muscle fiber diameters of levator ani muscle in the patients of SUI and POP were smaller than that in the control group （ P 〈 0.05 ）. Conclusion There are obvious fibrosis and atrophy of levator ani muscle fiber in the patients of SUI and POP, which resulted in the dysfunction of pelvic floor.

关 键 词：女性盆底功能障碍疾病 肛提肌 超微结构 

分 类 号：R711[医药卫生—妇产科学]