MMP-9、TIMP-1与Ⅲ型胶原在压力性尿失禁患者阴道壁组织中的表达及意义

Research on expression and significance of MMP-9,TIMP-1 and Collagen Ⅲin vaginal wall of patients with stress urinary incontinence

目的研究基质金属蛋白酶-9(MMP-9)及金属蛋白酶组织抑制剂(TIMP-1)与Ⅲ型胶原与压力性尿失禁(SUI)发病的关系。方法选择宁夏医科大学附属医院妇产科收治的SUI患者67例为研究组,并分为SUI组(36例)和SUI+盆腔器官脱垂(POP)组(31例)。选择同期非SUI和POP患者20例作为对照组。采用免疫组化方法测定阴道前壁组织中MMP-9、TIMP-1及Ⅲ型胶原蛋白的表达。结果SUI组、SUI+POP组及对照组MMP-9的阳性表达率分别为75.0%、77.4%和15.0%,TIMP-1的阳性表达率分别为19.4%、25.8%和90.0%,Ⅲ型胶原的阳性表达率分别为25.0%、22.5%和90.0%。SUI和SUI+POP组MMP-9、TIMP-1和Ⅲ型胶原的表达均明显高于对照组(P<0.01)。但SUI组与SUI+POP组三者的表达比较,差异均无统计学意义(P>0.05)。MMP-9与Ⅲ型胶原呈负相关(r=-0.523,P<0.01);TIMP-1与Ⅲ型胶原呈正相关(r=0.626,P<0.01)。结论MMP-9与TIMP-1的共同作用可能使胶原分解增加,盆底组织中胶原蛋白的减少是SUI发病的重要原因。

Objective To detect the status of collagen metabolism in pelvic floor of patients with stress urinary incontinence （SUI）,and to explore the etiology of SUI. Methods A total of 36 patients with SUI and 31 patients with SUI and pelvic organ prolapse （SUI＋POP group） who underwent operation in Ningxia Medical University were recruited in this study,as well as 20 patients without SUI or POP as control. Expression of MMP-9,TIMP-1 and Collagen Ⅲ in vagina anterior wall were detected by immunohistochemistry. Results Positive rates of MMP-9 were 75.0%,77.4% and 15.0% in SUI group,SUI＋POP group and control group,respectively. Positive rates of TIMP-1 were 19.4%,25.8% and 90.0% and the positive rates of Collagen Ⅲ were 25.0%,22.5% and 90.0%,respectively. Significant differences of MMP-9,TIMP-1 and type Ⅲ were observed between SUI,SUI＋POP group and the control group （all P0.01）. But no significant difference was found between SUI group and SUI＋POP group （P0.05）. Conclusion High expression of MMP-9 and low expression of TIMP-1 in vagina anterior wall could enhance collagen decomposition which might contribute to the development of SUI.