| Objective: Disease of female pelvic floor dysfunction (PFD) include aset of disease,which caused by the pelvic support structure defects ordegradation, injury and dysfunction. Extracellular matrix(ECM) is the mainingredients of connective tissue in pelvic floor.The change of the content andstructure of ECM is closely related to PFD. In addition, RECK, gelatinase A,gelatinase B and its interaction has an important influence on the degradationprocess of ECM.In this study,we selected postmenopausal women with FFD,whosecardinal ligament had been tested in order to analyze the expression of RECKand gelatinase A,gelatinase B. And then analyze the relationship amongRECK and gelatinase A,gelatinase B as well as the effect RECK produced onthe development of PFD baesd on the expression of abovementioned factors.Methods:1Select41patients with PFD who had been treated by the department ofgynecology of people’s hospital of Hebei Province from November2011toSeptember2012as experimental group. They were divided into three groupsas follows: fifty patients with decentia, eleven patients with procidentia, fiftypatients with uterine prolapse of fourth-degree. Select40patients with theuterine benign tumor needed surgery of the corresponding period as controlgroup.2The expression of RECK and gelatinase A,gelatinase B were tested byS-P immunohistochemical technique.3Analyze the data with SPSS16.0. Analyze the experimental resultsamong each group with chi-square test.Test the correlation among RECK andgelatinase A,gelatinase B with Spearman rank correlation analysis. Analyzethe correlation between the expression of RECK/gelatinase A/gelatinase B and the extent of prolapse with two-way ordered categorical data of linear trendtest.It’s statistically significant when P<0.05.Results:1RECK and gelatinase A,gelatinase B are expressed both in theexperimental group and control group.The positive rate of RECK in theexperimental group and control group was53.7%,95%.There was statisticallysignificant between two groups（χ~2=18.019，P<0.05）. The positive rate ofgelatinase A in the experimental group and control group was65.9%,27.5%.There was statistically significant between two groups（χ~2=11.959，P<0.05）. The positive rate of gelatinase B in the experimental group andcontrol group was65.9%,22.5%.There was statistically significant betweentwo groups（χ~2=15.412，P<0.05）.2The experimental group was divided into three groups according toPOP-Q stage as follows:second-degree,third-degree and forth-degree. Thepositive rates of RECK in the above three groups were86.7%,36.4%,33.3%respectively.In addition, there was statistically significant betweensecond-degree and third-degree groups (P=0.012<0.0125)as well as betweensecond-degree and forth-degree groups (P=0.004<0.0125). There was notstatistically significant between third-degree and forth-degree groups(P=0.598>0.0125). The positive rates of gelatinase A in the above threegroups were46.7%,54.5%,93.3%respectively. There was not statisticallysignificant between second-degree and third-degree groups (P=0.5>0.0125)aswell as between third-degree and forth-degree groups (P=0.32>0.0125).Whereas there was statistically significant between second-degree andforth-degree groups (P=0.007<0.0125). The positive rates of gelatinase B inthe above three groups were40%,72.7%,86.7%respectively. There was notstatistically significant between second-degree and third-degree groups(P=0.104>0.0125)as well as between third-degree and forth-degree groups(P=0.346>0.0125). Whereas there was statistically significant betweensecond-degree and forth-degree groups (P=0.01<0.0125).3Analyze the correlation between the expression of RECK and the extent of prolapse with two-way ordered categorical data of linear trend test.χ~2=10.388,Linear-by-Linear Association=8.37(P<0.05),Deviating fromLinear-by-Linear Association=2.018(P>0.05).It indicated that there was alinear trend between RECK express and the extent of prolapse.In the wake ofthe extent of prolapse increasing, the expression of RECK was decreased.4After analyzing the data with two-way ordered categorical data of lineartrend test, there was a linear trend between gelatinase A express and the extentof prolapse(χ~2=8.118, Linear-by-Linear Association is7.086,P<0.05,Deviating from Linear-by-Linear Association is1.032,P>0.05). In the wake ofthe extent of prolapse increasing, the expression of gelatinase A was increased.Also,there was a linear trend between gelatinase B express and the extent ofprolapse(χ~2=7.579, Linear-by-Linear Association is7.086,P<0.05,Deviatingfrom Linear-by-Linear Association is0.493,P>0.05). In the wake of the extentof prolapse increasing, the expression of gelatinase B was increased.5Test the correlation among RECK and gelatinase A,gelatinase B withSpearman rank correlation analysis.It indicated that the expression of RECKnegatively correlated to gelatinase A (r=－0.319,P<0.05). The expression ofRECK negatively correlated to gelatinase B (r=－0.459,P<0.01). Theexpression of gelatinase A and B unrelated (r=0.55,P>0.05).Conclusions:1The expression of RECK in the experimental group is lower than it inthe control group.Whereas the expression of gelatinase A and B in theexperimental group is higher than it in the control group.In addition, theexpression of gelatinase A and B in the experimental group has increasingtrend.It’s suggested that the inhibition of RECK and gelatinase A,gelatinase Bexpress increased abnormally may contribute to the development of PFD.2In the wake of the extent of prolapse increasing, the expression ofRECK was decreased.It’s showed that RECK has protective effect onmaintaining ECM structure.The progress of PFD might be promoted when theexpression of RECK restrained.3In the II,III,IV degrees of experimental group, gelatinase A and B express increased was related with the decrease of RECK express.It indicatedthat RECK can inhibit gelatinase A and B express.If upregulate RECK expressor downregulate gelatinase A and B express at the level may preclude ordecrease the development of PFD. |
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