一氧化氮、血管活性肠肽与压力性尿失禁关系的实验研究

The experimental study of the relationship between the nitric oxide, vasoactive intestinal peptide and stress urinary incontinence

目的明确压力性尿失禁（SUI）模型SD老鼠的尿道、阴道、肛提肌中非肾上腺素非胆碱能神经递质一氧化氮（NO）与血管活性肠肽（VIP）的分布规律及其表达差异，探讨NO与VIP在SUI发病机制中的作用。方法从成功建模的Sprague—Dawley（SD）雌性大鼠中选择12只作为实验组，另外12只未经任何处理的正常大鼠作为对照组。处死所有实验对象，取尿道、阴道、肛提肌行HE染色及免疫组化染色（ABC法）检测上述组织内NO与VIP的分布规律及其表达差异，用积分光密度衡量，结果用独立样本t检验进行统计学分析。结果（1）HE染色见对照组大鼠的尿道，阴道、肛提肌染色均匀，各种细胞体积大小正常，肌纤维排列整齐；实验组表现为组织染色不均匀，组织水肿，萎缩变薄，肌纤维排列疏松、稍紊乱，有少量炎症反应及细胞坏死。（2）免疫组化染色表明对照组大鼠尿道、阴道、肛提肌NO的积分光密度分别为：3．95±1．02、6．01±1．32、18．67±4．94。实验组则分别为：1．04±0．38、1．44±0．48、6．16±1．32；VIP的积分光密度在对照组大鼠尿道、阴道、肛提肌分别为：3．57±0．77、7．15±1．67、20．29±3．39。实验组则分别为：0．73±0．23、2．51±0．60、3．69±1．24。对照组和实验组大鼠尿道、阴道、肛提肌中NO与VIP的表达有显著差异，差异有统计学意义（P〈0．01）。结论（1）盆底肌肉组织变性，水肿导致盆底支持力量减弱可能与SUI发生有关；（2）非肾上腺索非胆碱能神经递质NO和VIP在血管周围最多，主要在肌浆中表达；实验组与对照组的差异说明NO与VIP参与了SUI的发生、发展。

cholinergic Objectives To determine both the distribution and expression of non - adrenergic and non - （NANC） nitric oxide （NO） and vasoactive intestinal peptide （VIP） in the urethra, vagina, elevator ani muscle of the SUI model rats. And to clarify their roles in the pathogencsis of SUI. Methods Choosing 12 SUI SD rats as experimental group and the other 12 normal SD rats as control group, both groups were killed and taken away the whole pelvic tissue including the urethra, vagina and elevator ani muscle. The urethra, vagina and elevator ani muscle were examined by HE dyeing and immunohistochemically （ ABC dyeing）. The results of immunohistochemistry were calculated with the integrated optical density and analysed statistically with independent sample t - test. Results （ 1 ） HE staining shows that the urethra, vagina, elevator ani muscle have the uniform staining, normal size in all kinds of ceils and regularly arranged muscle fibers in control group. However the uneven staining, tissue edema, atrophy thinning, muscle fiber arranged loosely and disordered slightly, a small amount of inflammation and cell necrosis were seen in the experimental group. （ 2 ） The results shows that the integrated optical density of nitric oxide （NO） in urethra, vagina, levator ani muscle were 3.95 ± 1.02, 6.01 ± 1.32, 18.67±4.94 in the control group and were 1.04±0.38, 1.44 ±0.48, 6.16 ± 1.32 in the experimental group. In control group, the integrated optical density of vasoactive intestinal peptide （VIP） were 3.57 ±0. 77, 7. 15 ± 1.67,20.29 ± 3.39 in urethra, vagina, levator ani muscle, which were 0.73 ± 0.23,2.51± 0.60, 3.69 ± 1.24 in the experimental group. Both the expression of NO and VIP between the control group and experimental group in urethra, vagina, levator ani muscle have the signifieant difference. The difference has the statistical significance（ p 〈0.01 ）. Conclusions （ 1 ） The degeneration, edema of pelvic floor muscle, leading to weaken the pelvic floor strength, maybe relate to the pathogenesis of SUI. （2）NO and VIP locate in plasma and are the most near the vascular. The difference of nitric oxide （NO） and vasoactive intestinal peptide （VIP） in the urethra, vagina, levator ani muscle between the experimental group and control group indicates that NO and VIP may play a role in the development of SUI.