Pierce Lisa M, Baumann Shannon, Rankin Michelle R, Wasserman Richard M, Biaggi Arabella, Kuehl Thomas J, Coates Kimberly W
Department of Obstetrics and Gynecology, Scott & White Hospital, Temple, TX 76508, USA.
Am J Obstet Gynecol. 2007 Jul;197(1):60.e1-9. doi: 10.1016/j.ajog.2007.02.037.
This study was undertaken to evaluate histologically the levator ani muscle and paravaginal attachments in squirrel monkeys with and without pelvic organ prolapse.
Serial sections from 19 females were processed with routine histology stains. Fiber typing was performed with antifast (type II) and antislow (type I) skeletal myosin antibodies, and apoptotic nuclei were examined by dUTP nick-end labeling (TUNEL).
Gross disruption of the levator ani muscle and its innervation was not observed in animals with or without visible support defects. Myogenic changes occurred more frequently in the pubocaudalis than iliocaudalis muscles, and a significant association was found with aging (P < .05, Fisher exact test) but not with pelvic organ prolapse or parity. Neurogenic changes were observed in 3 of 13 multiparous monkeys. Myocyte diameter increased in animals with pelvic organ prolapse compared with age-, weight-, and parity-matched animals without pelvic organ prolapse (P = .005) and correlated with levator ani muscle wet weight (R = 0.76; P = .0006). In the paravaginal attachments, the numbers of fibroblasts and apoptotic nuclei were not different between animals with and without pelvic organ prolapse, but parity was associated with increased apoptosis (P = .025).
Vaginal prolapse in the squirrel monkey does not result from atrophy or gross disruption of the levator ani muscle or its innervation. As in women, myogenic changes are a common finding in the levator ani muscle and increase with aging, whereas denervation with subsequent reinnervation occurs in some multiparous monkeys.
本研究旨在通过组织学方法评估有无盆腔器官脱垂的松鼠猴的肛提肌和阴道旁组织附着情况。
对19只雌性松鼠猴的连续切片进行常规组织学染色处理。使用抗快肌（II型）和抗慢肌（I型）骨骼肌肌球蛋白抗体进行纤维分型，并用脱氧尿苷三磷酸缺口末端标记法（TUNEL）检测凋亡细胞核。
在有或无明显支撑缺陷的动物中，均未观察到肛提肌及其神经支配的严重破坏。耻骨尾骨肌比髂尾骨肌更常发生肌源性变化，且与衰老显著相关（P <.05，Fisher精确检验），但与盆腔器官脱垂或产次无关。在13只经产猴中有3只观察到神经源性变化。与年龄、体重和产次匹配但无盆腔器官脱垂的动物相比，有盆腔器官脱垂的动物的肌细胞直径增加（P =.005），且与肛提肌湿重相关（R = 0.76；P =.0006）。在阴道旁组织附着处，有和无盆腔器官脱垂的动物之间成纤维细胞数量和凋亡细胞核数量无差异，但产次与凋亡增加相关（P =.025）。
松鼠猴的阴道脱垂并非由肛提肌及其神经支配的萎缩或严重破坏所致。与人类女性一样，肌源性变化在肛提肌中很常见且随年龄增长而增加，而在一些经产猴中会发生去神经支配及随后的再神经支配。
