Jóźwik M, Lotocki W, Jóźwik M
Department of Gynaecology and Septic Obstetrics, School of Medicine, Białystok, Poland.
Int Urol Nephrol. 1996;28(4):485-94. doi: 10.1007/BF02550955.
The aim of the study was the investigation of the biochemical condition of elements likely to directly participate in active closing of the urethral lumen. We estimated glycogenolysis in urinary bladder, perivesical connective tissue and levator ani muscle (LAM) samples obtained intraoperatively from 80 stress incontinent women. Glycogen content as well as activities of active and total glycogen phosphorylase and acid exo-1,4-alpha-glucosidase were measured. Material from the urinary bladder and perivesical connective tissue was insignificantly altered, and glycogen contents in the bladder (2.03 +/- 1.38 g/100 g wet tissue) were considered to be normal. In the LAM glycogenolysis was much more activated than in other tissues (p < 0.001 by Fischer's exact test). Of LAM specimens 78% (22/28) revealed imbalanced biochemistry of glycogen with activation of hydrolytic decomposition. We conclude that stress urinary incontinence in women is frequently associated with metabolic alterations in the periurethral striated fibres. This study indirectly supports our recent hypothesis on the pathogenesis of the disease in terms of muscle fibre type transitions.
本研究的目的是调查可能直接参与尿道腔主动闭合的元素的生化状况。我们评估了术中从80名压力性尿失禁女性获取的膀胱、膀胱周围结缔组织和肛提肌（LAM）样本中的糖原分解情况。测量了糖原含量以及活性糖原磷酸化酶、总糖原磷酸化酶和酸性外切-1,4-α-葡萄糖苷酶的活性。膀胱和膀胱周围结缔组织的物质变化不明显，膀胱中的糖原含量（2.03±1.38 g/100 g湿组织）被认为是正常的。在LAM中，糖原分解的激活程度比其他组织高得多（费舍尔精确检验，p<0.001）。78%（22/28）的LAM标本显示糖原生化失衡，水解分解激活。我们得出结论，女性压力性尿失禁常与尿道周围横纹肌纤维的代谢改变有关。本研究间接支持了我们最近关于该病发病机制的肌肉纤维类型转变假说。
