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目的探讨压力性尿失禁(SUI)患者尿道周围结缔组织中,核心蛋白聚糖(DCN)mRNA表达水平及Ⅲ型胶原含量变化及其相关性。方法将43例绝经前后妇女根据是否存在SUI分为SUI组(20例)和对照组(23例)。应用免疫组化法检测两组妇女尿道周围结缔组织中Ⅲ型胶原含量(以免疫组化指数表示);RT-PCR法检测DCNmRNA表达水平[以DCN与β肌动蛋白吸光度(A)值的比值表示]。结果SUI组患者尿道周围组织中DCNmRNA表达水平为0.76±0.16,对照组为0.76±0.16,两组比较,差异有统计学意义(P<0.05);SUI组患者Ⅲ型胶原含量为23±4,对照组为34±6,两组比较,差异也有统计学意义(P<0.05)。SUI组患者尿道周围组织中Ⅲ型胶原含量与DCNmRNA表达水平呈显著负相关(r=-0.720,P<0.05)。结论(1)尿道周围结缔组织中Ⅲ型胶原含量减少,可能是SUI发生的原因之一;(2)SUI患者尿道周围结缔组织中Ⅲ型胶原含量减少可能是由于局部DCNmRNA表达增强所致;(3)DCNmRNA表达增强,可能通过影响结缔组织的胶原含量和弹性性能参与SUI的发生。
Objective To investigate the expression of decorin (DCN) mRNA and the content of type Ⅲ collagen in connective tissue around urethra in patients with stress urinary incontinence (SUI) and its correlation. Methods 43 cases of premenopausal women were divided into SUI group (20 cases) and control group (23 cases) according to the presence or absence of SUI. Immunohistochemical method was used to detect the content of type Ⅲ collagen in the connective tissue around the urethra of the two groups (expressed by immunohistochemistry index); the expression of DCN mRNA was detected by RT-PCR [the ratio of DCN to β-actin absorbance (A) Said]. Results The expression level of DCN mRNA in the periurethral tissue of SUI group was 0.76 ± 0.16 and that of the control group was 0.76 ± 0.16, the difference was statistically significant (P <0.05). The SUI group had a level of collagen Ⅲ of 23 ± 4, The control group was 34 ± 6, the difference between the two groups was also statistically significant (P <0.05). There was a significant negative correlation between the content of type Ⅲ collagen and the expression of DCN mRNA in the periurethral tissues of SUI patients (r = -0.720, P <0.05). Conclusions (1) The decrease of type Ⅲ collagen in the connective tissue around the urethra may be one of the causes of SUI. (2) The decrease of type Ⅲ collagen in the connective tissue around the urethra may be caused by the enhancement of the expression of local DCN mRNA in SUI patients. 3) The expression of DCN mRNA is enhanced, which may be involved in the occurrence of SUI by affecting the collagen content and elasticity of connective tissue.