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目的:探讨盆腔器官脱垂(POP)患者外周血和盆底不同组织中线粒体DNA(mtDNA)及mtDNA 4977bp缺失(mtDNA4977)的含量变化与POP发生发展之间的关系。方法:采用实时定量PCR法分别检测26例POP患者和21例非POP患者外周血、骶韧带、阴道前后壁组织中mtDNA和mtDNA4977的相对含量。结果:(1)mtDNA在骶韧带中的含量,POP组明显低于非POP组,差异有统计学意义(P<0.05);而mtDNA在POP患者的外周血、阴道前壁和后壁中的含量,与非POP组比较,差异均无统计学意义(P>0.05)。mtDNA4977在POP患者的外周血、骶韧带、阴道前壁和后壁中的含量均显著高于非POP患者,差异有统计学意义(P<0.05)。无论mtDNA还是mtDNA4977,其含量在阴道前壁和后壁之间均无显著差异(P>0.05)。(2)随着POP程度不断加重(分析0到Ⅲ期POP),发现骶韧带中mtDNA含量呈下降趋势,而外周血、阴道前壁和后壁中此趋势不明显;在外周血、骶韧带、阴道前壁和后壁中mtDNA4977的比例却显著增加(P<0.05)。(3)POP患者外周血、骶韧带及阴道壁中mtDNA与mtDNA4977含量均无明显相关性(P>0.05)。mtDNA在POP患者外周血和骶韧带之间呈正相关(P<0.05),而mtDNA4977在POP患者外周血和骶韧带之间无显著相关性(P>0.05)。结论:mtDNA的消耗和mtDNA4977比例增加可能在POP分子水平的发病机制中起重要作用。
Objective: To investigate the relationship between changes of mitochondrial DNA (mtDNA) and mtDNA4977bp (mtDNA4977) in peripheral blood and pelvic floor of patients with pelvic organ prolapse (POP) and the occurrence and development of POP. Methods: The relative contents of mtDNA and mtDNA4977 in peripheral blood, sacral ligament and anterior vaginal wall of 26 POP patients and 21 non-POP patients were detected by real-time PCR. Results: (1) The content of mtDNA in sacral ligaments was significantly lower in POP group than in non-POP group (P <0.05), while mtDNA was found in peripheral blood, anterior vaginal wall and posterior wall of POP Content, compared with non-POP group, the difference was not statistically significant (P> 0.05). The content of mtDNA4977 in peripheral blood, sacral ligament, anterior vaginal wall and posterior wall of POP patients was significantly higher than that of non-POP patients (P <0.05). No matter mtDNA or mtDNA4977, there was no significant difference between the anterior vaginal wall and the posterior wall (P> 0.05). (2) The mtDNA content in the sacral ligament decreased with the increasing degree of POP (analysis of 0 to 3 periods of POP), while the trend was not obvious in the peripheral blood, anterior vaginal wall and posterior wall. In the peripheral blood, the sacral ligaments , The ratio of mtDNA4977 in the anterior vaginal wall and posterior wall increased significantly (P <0.05). (3) There was no significant correlation between mtDNA and mtDNA4977 content in peripheral blood, sacral ligament and vaginal wall of POP patients (P> 0.05). There was a positive correlation between mtDNA and peripheral sacral ligament in patients with POP (P <0.05), while mtDNA4977 had no significant correlation between peripheral blood and sacral ligament in patients with POP (P> 0.05). Conclusion: The increase of mtDNA 4977 and mtDNA4977 may play an important role in the pathogenesis of POP molecular level.