压力性尿失禁患者盆底超声参数与细胞外基质重塑、细胞凋亡的相关性研究

The correlation of pelvic floor ultrasound parameter with extracellular matrix remodeling and apoptosis in patients with stress urinary incontinence

目的:压力性尿失禁患者盆底超声参数与细胞外基质重塑、细胞凋亡的相关性。方法:选择2015年3月~2017年8月在湖北省天门市第一人民医院接受手术治疗的压力性尿失禁患者作为研究的SUI组,同期在湖北省天门市第一人民医院因子宫良性病变需接受子宫全切除术的患者作为研究的对照组。术前进行盆底超声检查并测定膀胱颈移动度(BND),术后收集盆底组织并测定Col-I、Col-Ⅲ、转化生长因子(TGF)-β1、基质金属蛋白酶(MMP)1、MMP9、金属蛋白酶组织抑制剂(TIMP)1、E-cadherin、Bax、Bcl-2、Bcl-xL、Caspase-3、缺氧诱导因子(HIF)-1α的含量。结果:SUI组患者盆底超声参数BND显著高于对照组;SUI组患者盆底组织中Col-I、Col-Ⅲ、TIMP1、E-cadherin、Bcl-2、Bcl-xL的含量显著低于对照组,TGF-β1、MMP1、MMP9、Bax、Caspase-3、HIF-1α的含量显著高于对照组;SUI组中高BND患者盆底组织中Col-I、Col-Ⅲ、TIMP1、E-cadherin、Bcl-2、Bcl-xL的含量显著低于低BND患者,TGF-β1、MMP1、MMP9、Bax、Caspase-3、HIF-1α的含量显著高于低BND患者。差异均有统计学意义(P<0.05)。结论:压力性尿失禁患者盆底超声参数BND的变化与盆底组织中细胞外基质重塑、细胞凋亡密切相关。

Objective:To study the correlation of pelvic floor ultrasound parameter with extracellular matrix remodeling and apoptosis in patients with stress urinary incontinence.Methods:Patients with stress urinary incontinence who underwent surgical treatment in Tianmen First People's Hospital in Hubei Province between March 2015 and August 2017 were selected as the SUI group of the research and patients who underwent total hysterectomy due to benign uterine lesions in Tianmen First People's Hospital in Hubei Province over the same period were selected as the control group of the research.Pelvic floor ultrasonography was done before surgery to measure the bladder neck descent(BND),and pelvic floor tissue was collected after surgery to determine the contents of Col-I,Col-Ⅲ,TGF-β1,MMP1,MMP9,TIMP1,E-cadherin,Bax,Bcl-2,Bcl-xL,Caspase-3 and HIF-1α.Results:The pelvic floor ultrasound parameter BND of SUI group was significantly higher than that of control group;Col-I,Col-Ⅲ,TIMP1,E-cadherin,Bcl-2 and Bcl-xL contents in the pelvic floor tissue of SUI group were significantly lower than those of control group whereas TGF-β1,MMP1,MMP9,Bax,Caspase-3 and HIF-1αcontents were significantly higher than those of control group;Col-I,Col-Ⅲ,TIMP1,E-cadherin,Bcl-2 and Bcl-xL contents in the pelvic floor tissue of SUI group of patients with high BND were significantly lower than those of patients with low BND whereas TGF-β1,MMP1,MMP9,Bax,Caspase-3 and HIF-1αcontents were significantly higher than those of patients with low BND.Conclusion:The change of pelvic floor ultrasound parameter BND in patients with stress urinary incontinence is closely related to the extracellular matrix remodeling and apoptosis in pelvic floor tissue.