[1]高 鑫,贾红娥,李 倩,等.盆底三维超声参数联合血清基质金属蛋白酶-1、骨桥蛋白、结缔组织生长因子水平对压力性尿失禁疾病严重程度的预测价值[J].陕西医学杂志,2023,52(2):149-153.[doi:DOI:10.3969/j.issn.1000-7377.2023.02.007]
 GAO Xin,JIA Hong'e,LI Qian,et al.Predictive value of three-dimensional pelvic floor ultrasound parameters combined with serum MMP-1,OPN and CTGF in severity of stress urinary incontinence[J].,2023,52(2):149-153.[doi:DOI:10.3969/j.issn.1000-7377.2023.02.007]
点击复制

盆底三维超声参数联合血清基质金属蛋白酶-1、骨桥蛋白、结缔组织生长因子水平对压力性尿失禁疾病严重程度的预测价值
分享到:

《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
52
期数:
2023年2期
页码:
149-153
栏目:
临床研究
出版日期:
2023-02-05

文章信息/Info

Title:
Predictive value of three-dimensional pelvic floor ultrasound parameters combined with serum MMP-1,OPN and CTGF in severity of stress urinary incontinence
作者:
高 鑫1贾红娥2李 倩3康旺旺1
(1.榆林市第二医院超声诊断科,陕西 榆林 719000; 2.延安大学附属医院超声科,陕西 延安 716000; 3.西北妇女儿童医院医学超声中心,陕西 西安 710061)
Author(s):
GAO XinJIA Hong'eLI QianKANG Wangwang
(Deparment of UItrasonic Diagnosis,Yulin No.2 Hospital,Yulin 719000,China)
关键词:
压力性尿失禁 盆底三维超声参数 基质金属蛋白酶-1 骨桥蛋白 结缔组织生长因子 疾病严重程度
Keywords:
Stress urinary incontinence Three-dimensional ultrasound parameters of pelvic floor Matrix metalloproteinase-1 Osteopontin Connective tissue growth factor Disease severity
分类号:
R 694.54
DOI:
DOI:10.3969/j.issn.1000-7377.2023.02.007
文献标志码:
A
摘要:
目的:探讨盆底三维超声参数联合血清基质金属蛋白酶-1(MMP-1)、骨桥蛋白(OPN)、结缔组织生长因子(CTGF)水平对压力性尿失禁疾病严重程度的预测价值。方法:选择280例压力性尿失禁患者作为观察组,另选同期的100例健康体检者作为对照组。所有受试者均在Valsalve动作下检测盆底三维超声参数、血清MMP-1、OPN、CTGF表达水平,分析不同严重程度的压力性尿失禁患者盆底三维超声参数、血清MMP-1、OPN、CTGF表达水平的差异性,使用多因素Logistic回归分析和受试者工作特征曲线(ROC)下面积(AUC)评价盆底三维超声参数、血清MMP-1、OPN、CTGF与压力性尿失禁疾病的关系。结果:观察组膀胱颈移动度、尿道倾斜角、尿道旋转角、膀胱尿道后角和裂孔面积均大于对照组(均P<0.05); 观察组血清MMP-1、OPN、CTGF表达水平均高于对照组(均P<0.05); 随着压力性尿失禁疾病严重程度的增大,膀胱颈移动度、尿道倾斜角、尿道旋转角、膀胱尿道后角和裂孔面积均随之增大,血清MMP-1、OPN、CTGF表达水平均随之升高(均P<0.05); 经多因素Logistic回归分析,膀胱颈移动度、裂孔面积、血清MMP-1、OPN、CTGF均是压力性尿失禁疾病的独立预测因素(均P<0.05); 经ROC曲线分析,膀胱颈移动度、裂孔面积、血清MMP-1、OPN联合CTGF预测压力性尿失禁疾病的AUC为0.915。结论:盆底三维超声参数、血清MMP-1、OPN、CTGF与压力性尿失禁疾病严重程度密切相关,其中膀胱颈移动度、裂孔面积、血清MMP-1、OPN联合CTGF预测压力性尿失禁疾病严重程度的效能较高。
Abstract:
Objective:To analyze the predictive value of three-dimensional pelvic floor ultrasound parameters combined with serum matrix metalloproteinase-1(MMP-1),osteopontin(OPN)and connective tissue growth factor(CTGF)in the severity of stress urinary incontinence.Methods:A total of 280 patients with stress urinary incontinence were selected as the observation group,and 100 healthy people in the same period were selected as the control group.Pelvic floor three-dimensional ultrasound parameters,serum MMP-1,OPN and CTGF expression levels were detected in all subjects under Valsalve action,and the differences of pelvic floor three-dimensional ultrasound parameters,serum MMP-1,OPN and CTGF expression levels in patients with stress urinary incontinence of different severity were analyzed.Multivariate Logistic regression analysis and the area under ROC curve(AUC)were used to evaluate the relationship between pelvic floor three-dimensional ultrasound parameters,serum MMP-1,OPN,CTGF and stress urinary incontinence.Results:The bladder neck mobility,urethral inclination angle,urethral rotation angle,posterior urethral angle and hiatus area in the observation group were higher than those in the control group(all P<0.05).The expression levels of MMP-1,OPN and CTGF in the observation group were higher than those in the control group(all P<0.05).With the increase of the severity of stress urinary incontinence,the bladder neck mobility,urethral inclination angle,urethral rotation angle,posterior urethral angle and hiatal area were increased,and the expression levels of MMP-1,OPN and CTGF in serum were increased(all P<0.05).Multivariate Logistic regression analysis showed that bladder neck mobility,hiatal area,serum MMP-1,OPN and CTGF were independent predictors of stress urinary incontinence(all P<0.05).ROC curve analysis showed that the AUC of bladder neck mobility,hiatal area,serum MMP-1,OPN combined with CTGF in predicting stress urinary incontinence was 0.915.Conclusion:Pelvic floor three-dimensional ultrasound parameters,serum MMP-1,OPN and CTGF are closely related to the severity of stress urinary incontinence.Bladder neck mobility,hiatal area,serum MMP-1 and OPN combined with CTGF have a high efficacy in predicting stress urinary incontinence.

参考文献/References:

[1] 陈惠英,许红雁,钟永红,等.产后压力性尿失禁的腹压漏尿点压及对应的超声参数研究[J].中国妇幼健康研究,2020,31(1):117-121.
[2] 陈 庆,张 欣,谢秀英.女性盆底功能障碍康复训练研究进展[J].陕西医学杂志,2020,49(11):1531-1533.
[3] 江宁珠,姜 伟,黄翠平,等.盆底三维超声判断压力性尿失禁患者盆底功能损伤和疗效的价值[J].医学影像学杂志,2021,31(4):654-657.
[4] 苏世文,曹晓丽,吴 瑾.血清基质金属蛋白酶-1、骨桥蛋白、结缔组织生长因子水平与子宫切除术后患者盆底功能障碍发生的相关性研究[J].中国性科学,2021,30(9):110-113.
[5] 余珊珊,郑转梅,乞艳华,等.经会阴二维及三维超声对压力性尿失禁患者TVT-O手术前后盆底结构的观察[J].陕西医学杂志,2017,46(2):193-195,233.
[6] 史 畅,夏志军.经会阴超声检查女性压力性尿失禁患者盆底结构变化的临床意义[J].实用妇产科杂志,2021,37(1):52-56.
[7] 肖 汀,黄伟俊,张新玲,等.经会阴超声联合临床因素预测女性压力性尿失禁的可行性研究[J].中华超声影像学杂志,2019,28(9):807-811.
[8] Bokne K,Malin S,Samuelsson E.Self-management of stress urinary incontinence:Effectiveness of two treatment programmes focused on pelvic floor muscle training,one booklet and one internet-based[J].Scandinavian Journal of Primary Health Care,2019,37(3):1-8.
[9] 汪荣金,朱小刚,林菊华.子宫切除术后压力性尿失禁患者盆底超声相关参数与MMP-1和MMP-9的关系[J].中国妇幼保健,2021,36(16):3702-3705.
[10] Chen L,Luo D,Chen X,et al.Development of predictive risk models of postpartum stress urinary incontinence for primiparous and multiparous women[J].Urologia Internationalis,2020,104(9):1-9.
[11] 徐 静,王 旭,房桂英,等.产后盆底功能障碍初产妇分娩后血清MMP-1、OPN、CTGF水平变化及其预测效能[J].山东医药,2022,62(9):37-41.
[12] 张武香,刘 佳,解育新.血清弹性蛋白酶抑制因子、骨桥蛋白及盆底电生理与盆底功能障碍性疾病的相关性研究[J].实用临床医药杂志,2021,25(14):78-83.
[13] Bennington J,Williams JK,Andersson KE.New concepts in regenerative medicine approaches to the treatment of female stress urinary incontinence[J].Current Opinion in Urology,2019,29(4):380-384.
[14] Qiu J,Qin M,Fan B,et al.Klotho protein reduced the expression of matrix metalloproteinase-1(MMP-1)and matrix metalloproteinase-3(MMP-3)in fibroblasts from patients with pelvic organ prolapse(POP)by down-regulating the phosphorylation of ERK1/2[J].Medical Science Monitor,2019,22(25):3815-3824.
[15] 赵白桦,文烈明,史庆玲,等.盆底超声研究尿道形态和活动度与女性压力性尿失禁的关系[J].中华超声影像学杂志,2021,30(7):615-619.
[16] 黄秀峰,郑 剑,王青娟,等.膀胱截石位和分腿抱膝位膀胱颈移动度及肛提肌裂孔面积的比较[J].中华超声影像学杂志,2020,29(7):618-622.
[17] Roth B,Furrer MA,Giannakis I,et al.Positive precystectomy biopsies of the prostatic urethra or bladder neck do not necessarily preclude orthotopic bladder substitution[J].Journal of Urology,2019,201(5):909-915.
[18] Smithling KR,Adams-Piper EE,Tran AM,et al.Efficacy of repeat midurethral sling for persistent or recurrent stress urinary incontinence:A fellows pelvic research network study[J].Obstetrical and Gynecological Survey,2020,75(2):96-97.
[19] 曾小丹,李常虹,张春雨.电刺激生物反馈对产后盆底功能障碍患者盆底肌力、盆底肌电位及MMP-2、TIMP-2、TGF-β1水平的影响[J].临床与病理杂志,2022,42(1):88-95.
[20] 高 颖,郭华峰,杨俊娟.补中益气丸联合生物电刺激康复训练对产后盆底功能康复影响的研究[J].陕西中医,2019,40(9):1208-1211.

相似文献/References:

[1]王巧云,任 伟.盆底超声测量前腔室结构参数对产后压力性尿失禁的诊断价值[J].陕西医学杂志,2022,51(12):1540.[doi:DOI:10.3969/j.issn.1000-7377.2022.12.017]
 WANG Qiaoyun,REN Wei.Diagnostic value of pelvic floor ultrasound measurement of anterior chamber structural parameters in postpartum stress urinary incontinence[J].,2022,51(2):1540.[doi:DOI:10.3969/j.issn.1000-7377.2022.12.017]

备注/Memo

备注/Memo:
基金项目:陕西省榆林市科技计划项目(YF-2021-61)
更新日期/Last Update: 2023-02-06