女性压力性尿失禁患者盆底结构的雌激素受体

目的 探讨女性盆底支持结构雌激素受体（ER）α和β与压力性尿失禁（SUI）发生的关系。方法 免疫组织化学及蛋白免疫印迹法检测绝经前后SUI患者肛提肌及周围组织中ERα和ERβ的表达。结果 绝经前、后SUI组肛提肌活检阳性率分别为11％、0,对照组分别为35％、33％。肛提肌未见ERα和ERβ表达,ERα和ERβ分布于肛提肌周围筋膜组织。ERβ在部分盆底筋膜组织切片标本染色呈阴性,绝经前、后SUI组盆底筋膜组织ERβ染色阳性率分别为57％、33％,显著低于对照组（P〈0．05）;绝经后各组盆底筋膜组织ERβ染色阳性率较绝经前显著降低（P〈0．05）。绝经前、后SUI组盆底筋膜组织ERα测定值分别为（4．43±2．64）％和（5．14±1．79）％,均显著低于相应对照组的（9．61±5．48）％和（10．88±2．90）％（P〈0．05）。蛋白免疫印迹法检测结果表明,盆底筋膜组织的ERβ表达低于ERα,SUI组ERα和ERβ表达较对照组降低。结论女性肛提肌未检测到ERα和ERβ。妇女绝经前SUI的发生与低雌激素水平有关。盆底筋膜组织ERα表达减少和ERβ表达阳性率降低与SUI发生有关。

Estrogen receptors in pelvic floor for female stress urinary incontinence

OBJECTIVE: To observe the statuses of estrogen receptor (ER) alpha and beta in the pelvic floor and its relation with stress urinary incontinence (SUI). METHODS: The ERa and ERP in levator ani muscle and pelvic floor structure of premenopausal and postmenopausal SUI patients were detected by immunohistochemical staining and Western blot. RESULTS: The positive biopsy rates in the premenopausal and postmenopausal SUI groups were 11% and 0, and the corresponding results in the control group were 35% and 33%. No ERalpha and ERbeta expression was detected in the levator ani muscle. ERalpha and ERbeta located in pelvic fasia tissue around the levator ani muscle. ERbeta was negatively stained in some segments of pelvic fasia tissue. The positive expression rates of ERbeta in the pelvic fasia tissue of premenopausal and postmenopausal SUI group were 57% and 33%, which were significantly lower than those in the control groups (P < 0.05). The positive expression rate of ERP in the pelvic fascia was significantly lower in postmenopausal group than in the premenopausal group (P < 0.05). The positive expression rates of ERa in the pelvic fasia tissue in the premenopausal and postmenopausal SUI groups were (4.43 +/- 2.64)% and (5.14 +/- 1.79)%, which were significantly lower than (9.61 +/- 5.48)% and (10.88 +/- 2.90)% in control group (P < 0.05). Western blot showed that ERbeta expression in pelvic fasia tissue was less than the expressions of ERalpha, ERalpha and ERbeta in the SUI group was also lower than that of the control group. CONCLUSION: ERalpha and ERbeta do not express in the levator ani muscle of women. Pathogenesis of premenopausal SUI correlates with lower serum estrodiol level and the expression of ER correlates SUI.