摘要
目的 通过对子宫韧带中胶原的含量、超微结构的研究 ,阐述压力性尿失禁 (SUI)和盆底膨出 (POP)患者子宫韧带的组织学改变 ,分析胶原与SUI和POP发生的关系。方法 绝经前后对照组和POP组及绝经后SUI组共 5组 73例子宫全切患者 ,取主韧带、宫骶韧带标本 ,光镜及电镜观察韧带组织学特点 ,测量胶原原纤维直径。结果 ①SUI和POP患者子宫韧带平滑肌束比较细碎 ,排列较凌乱 ,韧带胶原处于代谢活跃状态 ;②绝经前后POP组和SUI患者子宫韧带胶原原纤维直径明显大于对照组 (P <0 0 1 ) ;③各组研究对象主韧带与宫骶韧带的测量结果相近 ,主韧带与宫骶韧带胶原原纤维直径显著相关 (r =0 988,P <0 0 1 )。结论 ①SUI和POP患者子宫韧带平滑肌束比较细碎 ,排列较凌乱 ;②SUI和POP患者子宫韧带胶原原纤维直径明显增大 ;胶原处于代谢活跃状态 ,胶原的分解增加可能是SUI和POP发生的一个原因 ;③主韧带与宫骶韧带为组织同源性。
Objective To investigate the histological characteristics and collagen status in uterine ligaments. To detect the alteration of collagen ultrastructure in utrine ligaments and to explore whether the alteration can contribute to stress urinary incontinence(SUI) and pelvic organ prolapse(POP). Methods The cardinal ligament (Car lig.) and uterosacral ligament (U-S lig.) samples were obtained from 73 subjects undergoing hysterectomy. Collagen ultrastructure was examined with transmission electron microscopy. Results ① The smooth muscle fascicles in the patients of SUI and POP were thinner. Arrangement of smooth muscle fascicles was in disorder. ② The collagen constituting the ligaments was active in metabolism. The mean collagen fibril diameters in the SUI and POP groups were about 25% larger than that in the control groups ( P <0 01). ③ Histological characteristics of Car lig. and U-S lig. were similar. Conclusions ① Car lig. and U-S lig. are homologous. Abnormalities in arrangement of smooth muscle and the collagen ultrastructure are obvious in SUI and POP. ② The collagen fibril diameter in the SUI and POP sub-groups is significantly larger than that in the control groups. Those ligaments probably are less elastic and more likely to break. Predominance of collagen degradation during tissue repair may contribute to POP and SUI.
出处
《中国妇产科临床杂志》
2004年第1期6-8,39,共4页
Chinese Journal of Clinical Obstetrics and Gynecology
基金
国家自然科学基金项目 ( 3 0 170 975 )资助
