压力性尿失禁与尿道周围肌细胞凋亡的关系

Relationship between stress urinary incontinence and apoptosis of urethral peripheral muscle cells

目的初步探讨压力性尿失禁(SUI)与尿道周围肌细胞凋亡的关系。方法30只雌性SD大鼠随机分为阴道扩张组、卵巢切除组和阴道扩张+卵巢切除组,每组10只。分别模拟产伤和雌激素降低建立SUI大鼠模型。3月后对存活大鼠行尿动力检测以证实SUI的存在;取各组大鼠尿道周围肌组织冻存、切片,尿道周围肌细胞TUNEL检测,计算并比较各组细胞调亡率。以10只未建模雌性SD大鼠作为对照组。结果对照组、阴道扩张组、卵巢切除组和阴道扩张+卵巢切除组尿道周围肌细胞的细胞凋亡率分别为(34.7±3.59)%、(37.7±3.00)%、(47.1±5.17)%和(52.3±2.82)%。统计学分析显示,卵巢切除组和阴道扩张+卵巢切除组尿道周围肌细胞的细胞凋亡率显著高于对照组和阴道扩张组(P<0.01);卵巢切除组与阴道扩张+卵巢切除组,以及对照组与阴道扩张组尿道周围肌细胞的细胞凋亡率比较无显著差异(P>0.05)。结论产伤对尿道周围肌细胞的细胞凋亡影响不显著,而雌激素水平的降低可能会增加细胞凋亡的发生。

Objective To investigate the relationship between stress urinary incontinence （SUI） and apoptosis of urethral peripheral muscle cells. Methods Thirty female SD rats were randomly divided into colpectasis group, ovariectomy group and colpectasis ＋ ovariectomy group （n = 10）. SUI models were established to simulate birth injury and estrogen decrease. After 3 months, SUI was confirmed by urodynamics in the survival rats. The urethral peripheral muscle tissues were extracted and cryopreserved. TUNEL was performed on urethral peripheral muscle cells, and cell apoptosis rates were calculated and compared among groups. Another 10 female SD rats without colpectasis or ovariectomy were served as controls. Results The cell apoptosis rates of urethral peripheral muscle cells in control group, colpectasis group, ovariectomy group and colpectasis ＋ ovariectomy group were （34.7 ± 3.59） %, （ 37.7 ± 3.00） %, （47.1 ± 5.17 ） % and （ 52.3 ± 2.82） % , respectively. The cell apoptosis rates of urethral peripheral muscle cells in ovariectomy and colpectasis ＋ ovariectomy group were significantly higher than those in control group and colpectasis group （ P 〈 0.01 ）. However, there was no significant difference in cell appoptosis rates of urethral peripheral muscle cells between colpectasis group and control group （ P 〉 0.05）, and between ovariectomy group and colpectasis ＋ ovariectomy group （ P 〉 0.05 ）. Conclusion The birth injury has little impact on the apoptosis of urethral peripheral muscle cells, while the estrogen decrease may increase the cell apoptosis.