盆腔器官脱垂患者阴道壁和子宫骶、主韧带组织中神经纤维特点和VIP、NPY蛋白的表达

Expressions of VIP and NPY in vaginal wall and uterosacral and cardinal ligaments of pelvic organ prolapse patients

目的:研究盆腔器官脱垂(POP)患者阴道壁及子宫骶、主韧带的组织结构特点和神经纤维损伤情况,以及血管活性肠肽(VIP)、神经肽Y(NPY)的表达与POP疾病的关系。方法:选择POP轻度患者7例、重度患者8例,另取20例非POP患者作对照。选取患者阴道前壁和子宫骶、主韧带组织,采用HE染色进行病理组织学观察,免疫组化染色检测神经纤维标记PGP9.5蛋白,血管周围VIP、NPY蛋白的表达。结果:POP轻、重度组患者产次均高于对照组(F=12.196,P<0.001)。POP患者阴道壁及子宫骶、主韧带组织结构薄弱,神经纤维萎缩。3组神经纤维密度比较差异无统计学意义(P>0.05)。3组阴道壁及子宫骶、主韧带组织中血管周围VIP、NPY蛋白的表达差异有统计学意义(F=17.312、19.825、18.312、16.327、20.721、22.625,P<0.05),POP组高于对照组,POP重度组高于轻度组。结论:产次可能是POP发生的高危因素。POP患者阴道壁,子宫骶、主韧带组织中神经纤维萎缩。VIP、NPY在POP的发生、发展中起重要作用。

Aim：To research the nerve fiber damage and vasoactive intestinal peptide （ VIP） ,neuropeptide Y （ NPY） expression in vaginal wall , uterosacral and cardinal ligaments of patients with pelvic organ prolapsed （ POP） ,and to investi-gate their relation with occurrence of POP .Methods：A total of 15 patients with POP were allocated into three groups：mild POP group（7 patients）,severe POP group（8 patients）,and 20 patients without POP as the control .The uterosacral, cardi-nal ligament and anterior vaginal tissues were obtained .HE staining and immunohistochemical staining were applied to ob-serve the histological structure ,the density of nerve fiber bundles and the expressions of VIP and NPY proteins around vas -cular.Results：There was significant difference in parity among the three groups and the parity of patients in POP groups were higher（F=12.196,P〈0.001）.The structure of vaginal wall , uterosacral and cardinal ligaments in patients with POP were weak .The expressions of perivascular VIP and NPY proteins of vaginal wall ,uterosacral and cardinal ligaments among the three groups were significantly different （F=17.312,19.825,18.312,16.327,20.721,22.625,P〈0.05）,and which were higher in POP groups than those in control group ,and were higher in severe POP group than those in the mild POP group.Conclusion：Parity maybe a risk factor for the occurrence of POP .VIP and NPY may play important roles in occur-rence and development of POP .