【目的】通过检测水中待产产妇盆底组织中基质金属蛋白酶-1(MMP-1)和基质金属蛋白酶抑制物-1(TIMP-1)的表达,探讨水中待产对盆底组织是否具有保护作用。【方法】2009年6月至2011年2月,收集在中山大学孙逸仙纪念医院自愿选择水中待产的产...【目的】通过检测水中待产产妇盆底组织中基质金属蛋白酶-1(MMP-1)和基质金属蛋白酶抑制物-1(TIMP-1)的表达,探讨水中待产对盆底组织是否具有保护作用。【方法】2009年6月至2011年2月,收集在中山大学孙逸仙纪念医院自愿选择水中待产的产妇38例为试验组。同期、一般情况及产科条件相近、选择传统阴道试产的产妇70例为对照组。调查两组阴道分娩产妇孕期、产后42天压力性尿失禁症状(SUI)和盆腔器官脱垂(POP)情况。试验组和对照组最终分别有33、47例成功阴道分娩,于第三产程后取会阴侧切伤口底部组织,并进行石蜡包埋切片,用免疫组化SP染色法分别检测组织中MMP-1、TIMP-1的表达。【结果】1.两组孕期出现SUI症状的发生率差异无统计学意义(18.18%vs 31.91%,P=0.17),试验组产后42 d伴有SUI症状的发生率(2/33,6.06%)显著低于对照组(11/47,23.40%)(P=0.04)。两组阴道分娩产妇产后42 d POP发生率相近(24.24%vs 25.53%,P>0.05)。试验组盆底组织MMP-1阳性率(3/33,9.09%)显著低于对照组(32/47,68.09%)(P<0.001),试验组TIMP-1阳性率低于对照组,但差异没有统计学意义(12.12%vs 17.02%,P=0.546)。盆底组织MMP-1阳性表达与产后42 d SUI症状发生有关(OR=22.96,95%CI 2.81-187.73),盆底组织MMP-1阳性与产后42 d POP发生有关(OR=5.56,95%CI 1.88-16.42)。未发现TIMP-1与产后42 d SUI及POP的确切关系,对应OR(95%CI)分别为2.083(0.46-9.38)及3.02(0.83-11.06)。【结论】水中待产产妇盆底组织中MMP-1的阳性表达较低,可能与水中待产对盆底组织具有保护作用有关。展开更多
Pelvic organ prolapse （POP） is a disabling disorder in women characterized by a loss of pelvic floor support, leading to the herniation of the uterus into or through the vagina. POP is a complex problem that likely ...Pelvic organ prolapse （POP） is a disabling disorder in women characterized by a loss of pelvic floor support, leading to the herniation of the uterus into or through the vagina. POP is a complex problem that likely involves multiple mechanisms with limited therapies available, and is associated with defects in connective tissue including elastic fibers. This study was designed to investigate the expression of fibulin-5 and lysyl oxidase-like 1 （LOXL1） in the cardinal ligament in samples taken from the POP group compared to the non-POP group. Specimens were obtained during abdominal hysterectomy from the cardinal ligament of 53 women with POP and 25 age- and par- ity- matched women with non-POP among post-menopausal women with benign gynecologic pathology. Protein expression was evaluated using the immunohistochemical staining method. For statistical analyses, chi-square test and Spearman＇s correlation were used with the statistical package SPSS13.0 system. Our results showed that both fibulin-5 and LOXL1 expressions were decreased in the cardinal ligament in the POP group compared to the non- POP group （P 〈 0.05）. The expression of fibulin-5 and LOXL1 were correlated closely with the stage of POP, ac- companied by stress urinary incontinence and frequency of vaginal delivery （P 〈 0.05）, but had no relationship with post-menopausal state （P 〉 0.05）. The expression of fibulin-5 was positively associated with LOXL1 in POP （P 〈 0.05）. We conclude that changes in fibulin-5 and LOXL1 expression may play a role in the development of POP.展开更多
目的分析钙蛋白酶及钙蛋白酶抑制蛋白在压力性尿失禁(SUI)患者尿道周围组织中的表达及定位,探讨两者在压力性尿失禁发病中起的作用。方法选取20例行阴道无张力尿道中段悬吊术的SUI患者(SUI组)和20例行阴道壁囊肿剥除术的非SUI患者(对照...目的分析钙蛋白酶及钙蛋白酶抑制蛋白在压力性尿失禁(SUI)患者尿道周围组织中的表达及定位,探讨两者在压力性尿失禁发病中起的作用。方法选取20例行阴道无张力尿道中段悬吊术的SUI患者(SUI组)和20例行阴道壁囊肿剥除术的非SUI患者(对照组),采用免疫组化En Vision染色法对两组患者尿道周围组织石蜡切片中钙蛋白酶-1、钙蛋白酶-2和钙蛋白酶抑制蛋白的表达区域及水平进行检测。结果 SUI组和对照组尿道周围组织中的上皮细胞、平滑肌细胞中均有钙蛋白酶-1、钙蛋白酶-2和钙蛋白酶抑制蛋白的表达,但间质细胞中未见这三种蛋白的表达。钙蛋白酶-1的表达水平在SUI组和对照组上皮细胞和平滑肌细胞中的表达分别为2.71±0.45 vs2.41±0.41,2.01±0.40 vs 2.09±0.43,两组间比较,差异均无统计学意义(t分别=1.80、-0.46,P均>0.05)。钙蛋白酶-2的表达水平在SUI组和对照组上皮细胞和平滑肌细胞中的表达分别为3.07±0.36 vs 2.67±0.47,2.50±0.42 vs 2.08±0.51,两组间比较,差异均有统计学意义(t分别=2.35、2.28,P均<0.05)。钙蛋白酶抑制蛋白的表达水平在SUI组和对照组上皮细胞和平滑肌细胞中的表达分别为2.91±0.42 vs 3.23±0.39,2.69±0.43 vs 3.09±0.45,两组间比较,差异均有统计学意义(t分别=-2.19、-2.35,P均<0.05)。结论钙蛋白酶/钙蛋白酶抑制蛋白表达失衡可能参与压力性尿失禁的发生,钙蛋白酶-2对SUI的发病有促进作用,钙蛋白酶抑制蛋白对SUI的发病有保护作用。展开更多
文摘【目的】通过检测水中待产产妇盆底组织中基质金属蛋白酶-1(MMP-1)和基质金属蛋白酶抑制物-1(TIMP-1)的表达,探讨水中待产对盆底组织是否具有保护作用。【方法】2009年6月至2011年2月,收集在中山大学孙逸仙纪念医院自愿选择水中待产的产妇38例为试验组。同期、一般情况及产科条件相近、选择传统阴道试产的产妇70例为对照组。调查两组阴道分娩产妇孕期、产后42天压力性尿失禁症状(SUI)和盆腔器官脱垂(POP)情况。试验组和对照组最终分别有33、47例成功阴道分娩,于第三产程后取会阴侧切伤口底部组织,并进行石蜡包埋切片,用免疫组化SP染色法分别检测组织中MMP-1、TIMP-1的表达。【结果】1.两组孕期出现SUI症状的发生率差异无统计学意义(18.18%vs 31.91%,P=0.17),试验组产后42 d伴有SUI症状的发生率(2/33,6.06%)显著低于对照组(11/47,23.40%)(P=0.04)。两组阴道分娩产妇产后42 d POP发生率相近(24.24%vs 25.53%,P>0.05)。试验组盆底组织MMP-1阳性率(3/33,9.09%)显著低于对照组(32/47,68.09%)(P<0.001),试验组TIMP-1阳性率低于对照组,但差异没有统计学意义(12.12%vs 17.02%,P=0.546)。盆底组织MMP-1阳性表达与产后42 d SUI症状发生有关(OR=22.96,95%CI 2.81-187.73),盆底组织MMP-1阳性与产后42 d POP发生有关(OR=5.56,95%CI 1.88-16.42)。未发现TIMP-1与产后42 d SUI及POP的确切关系,对应OR(95%CI)分别为2.083(0.46-9.38)及3.02(0.83-11.06)。【结论】水中待产产妇盆底组织中MMP-1的阳性表达较低,可能与水中待产对盆底组织具有保护作用有关。
文摘Pelvic organ prolapse （POP） is a disabling disorder in women characterized by a loss of pelvic floor support, leading to the herniation of the uterus into or through the vagina. POP is a complex problem that likely involves multiple mechanisms with limited therapies available, and is associated with defects in connective tissue including elastic fibers. This study was designed to investigate the expression of fibulin-5 and lysyl oxidase-like 1 （LOXL1） in the cardinal ligament in samples taken from the POP group compared to the non-POP group. Specimens were obtained during abdominal hysterectomy from the cardinal ligament of 53 women with POP and 25 age- and par- ity- matched women with non-POP among post-menopausal women with benign gynecologic pathology. Protein expression was evaluated using the immunohistochemical staining method. For statistical analyses, chi-square test and Spearman＇s correlation were used with the statistical package SPSS13.0 system. Our results showed that both fibulin-5 and LOXL1 expressions were decreased in the cardinal ligament in the POP group compared to the non- POP group （P 〈 0.05）. The expression of fibulin-5 and LOXL1 were correlated closely with the stage of POP, ac- companied by stress urinary incontinence and frequency of vaginal delivery （P 〈 0.05）, but had no relationship with post-menopausal state （P 〉 0.05）. The expression of fibulin-5 was positively associated with LOXL1 in POP （P 〈 0.05）. We conclude that changes in fibulin-5 and LOXL1 expression may play a role in the development of POP.
文摘目的分析钙蛋白酶及钙蛋白酶抑制蛋白在压力性尿失禁(SUI)患者尿道周围组织中的表达及定位,探讨两者在压力性尿失禁发病中起的作用。方法选取20例行阴道无张力尿道中段悬吊术的SUI患者(SUI组)和20例行阴道壁囊肿剥除术的非SUI患者(对照组),采用免疫组化En Vision染色法对两组患者尿道周围组织石蜡切片中钙蛋白酶-1、钙蛋白酶-2和钙蛋白酶抑制蛋白的表达区域及水平进行检测。结果 SUI组和对照组尿道周围组织中的上皮细胞、平滑肌细胞中均有钙蛋白酶-1、钙蛋白酶-2和钙蛋白酶抑制蛋白的表达,但间质细胞中未见这三种蛋白的表达。钙蛋白酶-1的表达水平在SUI组和对照组上皮细胞和平滑肌细胞中的表达分别为2.71±0.45 vs2.41±0.41,2.01±0.40 vs 2.09±0.43,两组间比较,差异均无统计学意义(t分别=1.80、-0.46,P均>0.05)。钙蛋白酶-2的表达水平在SUI组和对照组上皮细胞和平滑肌细胞中的表达分别为3.07±0.36 vs 2.67±0.47,2.50±0.42 vs 2.08±0.51,两组间比较,差异均有统计学意义(t分别=2.35、2.28,P均<0.05)。钙蛋白酶抑制蛋白的表达水平在SUI组和对照组上皮细胞和平滑肌细胞中的表达分别为2.91±0.42 vs 3.23±0.39,2.69±0.43 vs 3.09±0.45,两组间比较,差异均有统计学意义(t分别=-2.19、-2.35,P均<0.05)。结论钙蛋白酶/钙蛋白酶抑制蛋白表达失衡可能参与压力性尿失禁的发生,钙蛋白酶-2对SUI的发病有促进作用,钙蛋白酶抑制蛋白对SUI的发病有保护作用。
