压力性尿失禁患者盆底组织E-cadherin和Vimentin表达水平及临床意义

Expression levels and clinical significance of E-cadherin and vimentin in pelvic floor tissue of women with stress urinary incontinence

目的探讨压力性尿失禁(SUI)患者盆底组织钙粘附蛋白E(E-cadherin)和波形蛋白(Vimentin)表达水平及临床意义。方法选择2016年6月-2018年6月在四川省人民医院就诊并接受手术治疗的74例SUI女性为研究对象,根据SUI的严重程度分为轻度SUI组(24例)、中度SUI组(26例)、重度SUI组(24例)。测定腹压漏尿点压力(ALPP)、功能性尿道长度(FUL)、最大尿道压(MUP)、最大尿道关闭压(MUCP),计算膀胱颈移动度(BND),检测E-cadherin、Vimentin m RNA表达水平。结果3组患者ALPP、MUCP、BND比较差异均有统计学意义(均P<0.05)。轻度SUI组盆底组织E-cadherin m RNA表达水平显著高于中度SUI组和重度SUI组(均P<0.05)。轻度SUI组盆底组织Vimentin mRNA表达水平显著低于中度SUI组和重度SUI组(均P<0.05)。3组Ⅰ型胶原(Col-Ⅰ)、Ⅲ型胶原(Col-Ⅲ)、转化生长因子-β1(TGF-β1)、基质金属蛋白酶1(MMP1)、基质金属蛋白酶9(MMP9)、基质金属蛋白酶组织抑制物1(TIMP1)表达水平比较差异均有统计学意义(均P<0.05)。E-cadherin与Col-Ⅰ、Col-Ⅲ、TIMP1呈正相关,与TGF-β1、MMP1、MMP9呈负相关;Vimentin与Col-Ⅰ、Col-Ⅲ、TIMP1呈负相关,与TGF-β1、MMP1、MMP9呈正相关。Vimentin、Col-Ⅰ、TGF-β1、MMP1、MMP9是SUI的危险因素,Ecadherin、Col-Ⅲ、TIMP1是SUI的保护因素。结论绝经期SUI患者盆底组织E-cadherin表达水平降低,Vimentin表达水平升高,二者呈显著负相关,且均参与疾病的发展。

Objective To explore the expression levels and clinical significance of E-cadherin and vimentin in pelvic floor tissue of menopausal women with stress urinary incontinence(SUI).Methods From June 2016 to June 2018,74 menopausal women with SUI diagnosed and treated by surgery in Sichuan Provincial People’s Hospital were selected and divided into mild SUI group(24 cases),moderate SUI group(26 cases),and severe SUI group(24 cases)according to the severity of SUI.Abdominal leak point pressure(ALPP),functional urethral length(FUL),and maximum urethral closure pressure(MUP)were measured.Bladder neck descent(BND)was calculated.The expression levels of E-cadherin and Vimentin m RNA were detected.Results There were statistically significant differences in ALPP,MUCP,and BND among the three groups(P<0.05).The expression level of E-cadherin m RNA in mild SUI group was statistically significantly higher than those in moderate SUI group and severe SUI group(P<0.05).The expression level of Vimentin m RNA in mild SUI group was statistically significantly lower than those in moderate SUI group and severe SUI group(P<0.05).There were statistically significant differences in the expression levels of Col-Ⅰ,Col-Ⅲ,TGF-β1,MMP1,MMP9,and TIMP1 among the three groups(P<0.05).E-cadherin was positively correlated with Col-Ⅰ,Col-Ⅲ,TIMP1 and negatively correlated with TGF-β1,MMP1,MMP9.Vimentin was negatively correlated with Col-Ⅰ,Col-Ⅲ,TIMP1 and positively correlated with TGF-β1,MMP1,MMP9.Vimentin,Col-Ⅰ,TGF-β1,MMP1,and MMP9 were risk factors of SUI.E-cadherin,Col-Ⅲ,and TIMP1 were protective factors of SUI.Conclusion The expression level of E-cadherin in pelvic floor tissue of menopausal women with SUI decreases,while the expression level of Vimentin increases,E-cadherin expression level is significantly negatively correlated with Vimentin expression level,both E-cadherin and Vimentin are involved into development of menopausal SUI.