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目的探讨阴道前壁组织雌激素受体亚型α/β(ERα/β)表达变化与压力性尿失禁(stress urinary in-continence,SUI)的相关性。方法采用免疫组化法检测2000年1月至2005年3月浙江大学医学院附属妇产科医院31例SUI患者(即SUI组:绝经前12例,绝经后19例)及26例非SUI妇女(即对照组:绝经前12例,绝经后14例)阴道前壁组织ERα/β表达,用H-score评分法定量。结果(1)ERα/β在阴道前壁组织鳞状上皮细胞、血管内皮细胞、平滑肌细胞、纤维细胞上均见表达。(2)绝经前SUI组ERα在血管内皮细胞、平滑肌细胞及纤维细胞中的表达较绝经前对照组显著降低(P<0.01)而在鳞状上皮细胞中的表达差异无显著性(P>0.05);绝经前SUI组ERβ在血管内皮细胞及纤维细胞中的表达较绝经前对照组显著降低(P<0.01),而在鳞状上皮细胞和平滑肌细胞中的表达差异无显著性(P>0.05);(3)绝经后两组间各细胞成分上ERα的表达差异均无显著性(P>0.05);SUI组纤维细胞上ERβ的表达较对照组显著降低(P<0.01)。结论绝经前SUI的发生与ERα/β表达水平下降均相关;绝经后阴道前壁纤维结缔组织ERβ表达水平的下降可能在绝经后SUI发病中起重要作用。
Objective To investigate the relationship between estrogen receptor subtype α / β (ERα / β) expression and stress urinary in-continence (SUI) in the anterior vaginal wall. Methods Thirty-one SUI patients (ie SUI group: 12 premenopausal women, 19 postmenopausal women) and 26 non-SUI women were enrolled in this study from January 2000 to March 2005 in the Affiliated Obstetrics and Gynecology Hospital of Zhejiang University School of Medicine. (Control group: premenopausal 12 cases, postmenopausal 14 cases) ERα / β expression in the anterior vaginal tissue, using H-score scoring method. Results (1) The expressions of ERα / β in squamous epithelial cells, vascular endothelial cells, smooth muscle cells and fibroblasts in the anterior vaginal wall were observed. (2) The expression of ERα in vascular endothelial cells, smooth muscle cells and fibroblasts in premenopausal SUI group was significantly lower than that in pre-menopausal control group (P <0.01), but not in squamous epithelial cells (P> 0.05 ). The expression of ERβ in vascular endothelial cells and fibroblasts in premenopausal SUI group was significantly lower than that in pre-menopausal control group (P <0.01), but not in squamous epithelial cells and smooth muscle cells (P> 0.05 (3) There was no significant difference in the expression of ERα between the two groups (P> 0.05). The expression of ERβ in SUI group was significantly lower than that in the control group (P <0.01). Conclusions The occurrence of pre-menopausal SUI is correlated with the decrease of ERα / β expression. The decrease of ERβ expression in pre-menopausal women may play an important role in the pathogenesis of postmenopausal SUI.