生殖医学杂志2013，Vol.22Issue(6)：430-435,6.DOI:10.3969/j.issn.1004-3845.2013.06.010
妊娠期和产后盆腔器官脱垂时肛提肌形态学及阴道粘膜神经表达特征
Neuromuscular characteristics in women with pelvic organ prolase during pregnancy and postpartum
滕莉荣 1边旭明 1朱兰 1郎景和 1刘俊涛 1杨剑秋 1任海涛 2赵燕环 2陈琳2
作者信息
- 1. 中国医学科学院,北京协和医学院,北京协和医院妇产科,北京100730
- 2. 中国医学科学院,北京协和医学院,北京协和医院神经内科,北京100730
- 折叠
摘要
Abstract
Objective:To investigate the pathologic changes of levator ani musle and innervation of vaginal mucosa in women with pelvic organ prolase(POP).Methods:One hundred primiparas were collected in the study.Their pelvic organ prolapse(POP)was assessed by the Pelvic Organ Prolapse Quantitative Examination(POP-Q)in the third trimester and around six weeks postpartum.After the third stage of labor,biopsy specimens of levitor ani muscle(LAM)and vagina wall were obtained and stained with histological techniques for examination of morphological characteristics.Vaginal mucosa specimens were stained with the following immunohistochemistry staining:PGP9.5,vasoactine intrestinal peptide (VIP)and neuropeptide Y (NPY),and the positive stained nerve fibers were calculated respectively.Results:The LAMs of the puerperal undergoing vaginal delivery presented acute and chronic neurogenetic and myogenetic changes.The type Ⅰ muscular fibers were predominant in patients with and without POP(78.5％-83.5％ during pregnancy and 78.3％-82.2％ postpartum).No significant difference was found in diameters and proportion of LAMs between women with and without POP(P＞0.05).No difference was observed between puerperants with and without POP concerning the diameters and ratio of muscular fibers(P＞0.05).There were significant differences in the diameter of type Ⅱ muscular fibers and the innervation of VIP and NPY nerve fibers between puerperants with POP and without POP(P＜0.05).Conclusions:The changes of morphology,muscular fiber diameters and proportions in LAMs of puerperants were not directly associated with POP postpartum.Different innervation of VIP and NPY nerve fibers in the lamina propria of the anterior vaginal wall may contribute to the pathogenesis of POP after delivery.关键词
妊娠/盆腔器官脱垂/肛提肌/阴道黏膜/神经纤维Key words
Pregnancy/Pelvic organ prolaps/Levator ani muscle/Vagina mucosa/Nerve fibers引用本文复制引用
滕莉荣,边旭明,朱兰,郎景和,刘俊涛,杨剑秋,任海涛,赵燕环,陈琳..妊娠期和产后盆腔器官脱垂时肛提肌形态学及阴道粘膜神经表达特征[J].生殖医学杂志,2013,22(6):430-435,6.
