目的：分析钙蛋白酶及钙蛋白酶抑制蛋白在压力性尿失禁（SUI）患者尿道周围组织中的表达及定位，探讨两者在压力性尿失禁发病中起的作用。方法选取20例行阴道无张力尿道中段悬吊术的SUI患者（SUI组）和20例行阴道壁囊肿剥除术的非SUI患者（对照组），采用免疫组化EnVision染色法对两组患者尿道周围组织石蜡切片中钙蛋白酶-1、钙蛋白酶-2和钙蛋白酶抑制蛋白的表达区域及水平进行检测。结果 SUI组和对照组尿道周围组织中的上皮细胞、平滑肌细胞中均有钙蛋白酶-1、钙蛋白酶-2和钙蛋白酶抑制蛋白的表达，但间质细胞中未见这三种蛋白的表达。钙蛋白酶-1的表达水平在SUI组和对照组上皮细胞和平滑肌细胞中的表达分别为2.71±0.45 vs 2.41±0.41，2.01±0.40 vs 2.09±0.43，两组间比较，差异均无统计学意义（t分别=1.80、-0.46，P均＞0.05）。钙蛋白酶-2的表达水平在SUI组和对照组上皮细胞和平滑肌细胞中的表达分别为3.07±0.36 vs 2.67±0.47，2.50±0.42 vs 2.08±0.51，两组间比较，差异均有统计学意义（t分别=2.35、2.28，P均＜0.05）。钙蛋白酶抑制蛋白的表达水平在SUI组和对照组上皮细胞和平滑肌细胞中的表达分别为2.91±0.42 vs 3.23±0.39，2.69±0.43 vs 3.09±0.45，两组间比较，差异均有统计学意义（t分别=-2.19、-2.35，P均＜0.05）。结论钙蛋白酶/钙蛋白酶抑制蛋白表达失衡可能参与压力性尿失禁的发生，钙蛋白酶-2对SUI的发病有促进作用，钙蛋白酶抑制蛋白对SUI的发病有保护作用。%Objective To investigate the expression and distribution of calpain and calpastatin in urethral surrounding tissue of SUI patients and explore the role of calpain and calpastatin in the pathogenesis of SUI. Methods The expressions of calpain-1, calpain-2 and calpastatin were detected with an EnVision immunohistochemistry assay in 40 paraffin-embedded samples of urethral surrounding tissue in SUI patients and control group. Results Calpain-1、calpain-2 and calpastatin were expressed in epithelial and smooth muscle tissue of SUI group and control group, but not found in interstitial cells. The expression levels of calpain-1 in epithelial tissue of SUI and control group were 2.71 ± 0.45 and 2.41 ± 0.38, and in smooth muscle tissue were 2.01±0.40 and 2.09±0.43. The differences were not statistical significance (t=1.80, -0.46, P>0.05). The expression levels of calpain-2 in epithelial tissue of SUI and control group were 3.07±0.36 and 2.67±0.47, and in smooth muscle tissue were 2.50±0.42 and 2.08±0.51. The differences were statistical significance(t=2.35, 2.28, P<0.05). The expression levels of calpastatin in epithelial tissue of SUI and control group were 2.91±0.42 and 3.23 ±0.39 respectively, and in smooth muscle tissue were 2.69 ±0.43 and 3.09 ±0.45 respectively. The differences were statistical significance (t=-2.19, -2.35, P<0.05). Conclusion The imbalance expression of calpain/calpastatin may be involved in the occurrence of stress urinary incontinence. Calpain-2 promotes the incidence of SUI,and calpastatin prevents the incidence of SUI.
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