细胞外基质在女性压力性尿失禁中的作用

Roles of extracellular matrix in female stress urinary incontinence

压力性尿失禁(stress urinary incontinence,SUI)是一种常见的女性盆底功能障碍性疾病,严重影响女性的生活质量和身心健康。影响SUI发生的危险因素包括妊娠、阴道分娩、衰老等,但这些因素几乎都与两种机制有关,一种是盆底及阴道支撑组织作用减弱,导致尿道及膀胱颈不能充分闭合;另一种是尿道括约肌自身功能缺陷,使尿道闭合不良。盆底支撑组织主要由结缔组织组成,而细胞外基质(extracellular matrix,ECM)是结缔组织的主要成分之一。目前,大量研究表明,盆底组织功能缺陷与ECM重塑相关,并且一些基于ECM的再生医学方法(如干细胞治疗)也用于SUI的研究。然而,关于ECM作用于SUI的具体机制及干细胞治疗如何通过ECM影响SUI的内在关系尚不清楚。本文查阅了近些年有关SUI机制及治疗的文献,总结并阐述了ECM与SUI发病的内在联系及进展,旨在为SUI治疗方案提供参考。

Stress urinary incontinence(SUI)is a common female pelvic floor dysfunction disease,which seriously affects the quality of life and physical and mental health of women.Risk factors for SUI include pregnancy,vaginal delivery,aging,etc.,but these factors are almost all related to two mechanisms:one is the weakening of pelvic floor and vaginal support tissues,leading to inadequate closure of the urethra and bladder neck;the other is the functional defect of the urethral sphincter muscle,resulting in poor closure of the urethral.The pelvic floor support tissues are mainly composed of connective tissues,and the extracellular matrix(ECM)is one of the main component of connective tissues.Currently,a large number of studies have shown that pelvic floor tissue dysfunction is related to ECM remodeling,and some regenerative medical methods based on ECM(such as stem cell therapy)are also used in the research of SUI.However,the specific mechanism of ECM acting on SUI and how stem cell therapy affects SUI through ECM are not yet clear.This work will review the literature on the mechanism and treatment of SUI in recent years,summarize and explain the intrinsic relationship and progress between ECM and the pathogenesis of SUI,and provide reference for SUI treatment plans.