压力性尿失禁患者阴道黏膜的神经表达

目的　探讨压力性尿失禁 (SUI)患者阴道黏膜神经组织学改变 ,分析神经表达与疾病发生的关系。方法　于手术中分别取SUI组患者 15例 (SUI组 )、盆腔器官脱垂患者 2 3例 (POP组 )、无SUI和POP的妇科良性疾病患者 15例 (对照组 )阴道前壁近尿道处黏膜。采用半定量免疫组化方法 ,观察阴道黏膜层的神经丝蛋白 (NF)表达。结果　阴道黏膜固有层中可见着色为棕色的神经纤维分布 ,依据表达阴性、弱阳性、阳性、强阳性的顺序 ,SUI组分别为 6、5、4、0例 ;POP组分别为 17、5、1、0例 ;对照组分别 3、2、4、6例。SUI组患者的阴道黏膜NF表达与对照组相比 ,差异有显著性(P <0 0 5 ) ,NF的表达与尿失禁的程度 (r =- 0 15 0 )和腹部漏尿点压力 (LPP) (r =- 0 198)无明显相关性 (P >0 0 5 )。POP组NF表达也低于对照组。结论　SUI患者的阴道黏膜层神经分布低于对照组 ,可能是SUI的发病机制之一。

Study of neural expression in vaginal mucosa of patients with urinary stress incontinence

Objective The aim of our study was to investigate the histological changes of vaginal mucosa innervation in stress urinary incontinence(SUI), to determine the alteration that contributed to them Methods Biopsy specimens of anterior vaginal wall were obtained from 56 subjects during operation, which belonged to one of the 3 groups: SUI(15 cases), POP(23 cases) and asymptomatic control(15 cases) Using immunohistochemical method we could semiquantitatively determine the expression of neurofilament (NF) in vaginal mucosa as the distribution of the nerve terminals Results There were brown stained nerve fibers in the lamina propria According to the expression staging(-, , , ), the number of patients was 6,5,4,0 cases in SUI group, 17,5,1,0 cases in POPgroup,and 3,2,4,6 cases in control group, respectively There was significant difference between SUI group and control group in the expression of NF( P <0 05)and the expression of nerve fiber had no correlation with the clinical severity and leak point pressure (LPP) in SUI group ( P >0 05) The expression of NF in POP group was also weaker than control Conclusion The SUI group had a significant less total innervation of vaginal mucosa than asymptomatic controls, which may contribute to the pathogenesis of SUI