绝经后压力性尿失禁患者盆底胶原分解及雌激素受体表达

Collagen Breakdown and Expression of Estrogen Receptor in Parauretheral Connective Tissues with Postmenopausal Stress Urinary Incontinence Women

目的:探讨盆底组织胶原分解代谢及雌激素受体(ER)亚型表达与绝经后压力性尿失禁(SUI)发生的关系。方法:选取绝经后SUI患者23例为研究组,因卵巢良性肿瘤或宫颈上皮内瘤变行手术治疗的绝经后患者18例为对照组,采用RT-PCR技术检测尿道旁组织基质金属蛋白酶-2(MMP-2)及其组织抑制因子(TIMP-2)mRNA表达;同时采用免疫组化技术检测ERα、ERβ表达。结果:①研究组尿道旁组织MMP-2mRNA表达较对照组明显升高,差异有高度统计学意义(P<0.01),且MMP-2/TIMP-2比值也较对照组明显升高(P<0.05);②绝经后妇女尿道旁组织均可发现ERα和ERβ表达,研究组尿道旁组织血管内皮细胞ERβ表达明显高于对照组(P<0.01),且与MMP-2mRNA表达呈正相关(spearman相关系数r=0.984,P<0.01)。结论:绝经后妇女可能通过尿道旁组织血管内皮细胞ERβ表达升高,介导局部组织胶原蛋白降解加速,导致SUI。

Objective：To investigate the relationship between collagen breakdown, expression of estrogen subtype receptor in parauretheral connective tissues and pathogenesis of postmenopausal stress urinary incontinence（SUI）. Methods：23 cases of postmenopausal SUI were selected as study group, 18 postmenopausal patients with benign ovary tumor or cervical intraepithelial neoplasia underwent operation were as control group. Reverse transcription-polymerase chain reaction （RT-PCR） was used to verify the mRNA level of matrix metalloproteinase-2 （ MMP-2 ） and Tissue inhibitors of metalloproteinases-2 （ TIMP-2 ） in parauretheral tissue. The expression of estrogen receptor（ERcx） and ERβ were detected by immunohistochemistry （ SP method）. Results：The expression of MMP-2 mRNA in study group was significant higher than-that in control group （ P〈0.01 ）. The ratios of MMP-2/TIMP-2 in study group was also higher than that in control group （ P 〈0.05）. ERa and ERβ were both detected in the parauretheral connective tissues in two groups. In study group, the expression of ERβ in vascular endothelium was significant higher than that in control group （ P 〈 0.01 ）, which was positive correlated with the levels of MMP-2 mRNA （spearman correlation coefficients （r） was 0.984, P〈0.01 ）. Conclusions：Increased expression of ERβ from vascular endothelium in parauretheral connective tissues has accelerated collagen breakdown, which leads to postmenopausal SUI.