模拟分娩产伤及绝经建立女性生殖器性唤起障碍大鼠模型及阴道微血管损害的致病机制研究

The incidence of female sexual arousal disorder is up to 21.5%. There are subjective and genital sexual arousal disorders. Female genital arousal disorder (FGSAD) refers to the organic organs of the organic lesions, including the reduction of sexual organs, vaginal congestion, relaxation, smoothness and clitoris congestion swelling disorders, of which the most common vaginal lesions. But the lack of clinical specimens and a standard animal model has become the limitation of FGSAD research and treatment. FGSAD may cause by genital injury combined hormone withdrawal. Previously,by simulating birth trauma of the female prolonged second stage and menopause physiological processes, we found that vaginal blood flow, contraction function and histology have changed dramatically which accords with the physiological changes of FGSAD, validated our hypothesis . Therefore, through the optimization of different processing methods to establish the rat model of FGSAD and evaluation of the best time and way by the rat model for arousal vaginal response, vaginal contraction function and histopathological techniques. Currently FGSAD pathogenic mechanism is unclear. Previous our study also found that the microvasculars of vaginal tissue were significantly reduced and VEGF decline in FGSAD. Therefore, we use molecular biology technology to understand the change of VEGF signaling pathway related artery and clear the pathogenic mechanisms of vaginal microvascular in FGSAD.

我国女性性唤起障碍发病率高达21.5%，分为主观和生殖器性唤起障碍。女性生殖器性唤起障碍（FGSAD）是指性器官的器质性病变，包括性器官敏感性的降低、阴道充血、松弛、滑润及阴蒂充血膨胀障碍等，其中阴道病变最为常见。因缺乏可靠的动物模型，已成为FGSAD研究和治疗的瓶颈。临床发现FGSAD在阴道产伤和绝经女性发病率较高，因此，其病因可能为阴道损伤和雌激素撤退最为重要。前期实验通过模拟女性分娩产伤及绝经生理过程构建动物模型，发现其阴道血流，收缩功能和组织学发生显著改变，符合FGSAD阴道病理变化。因此，本研究通过优化不同处理方式，利用阴道血流测定和组织学评估该FGSAD大鼠模型建立的最佳时间和方式，建立标准化FGSAD大鼠模型。目前FGSAD的致病机制不清楚，前期发现该模型阴道微血管显著减少。我们通过检测VEGF相关血管信号通路，明确FGSAD阴道组织微血管损害的致病机制。

1、本研究通过模拟产伤和绝经建立女性生殖器性唤起障碍（FGSAD）大鼠模型，与单纯的阴道扩张和单纯切除卵巢模型相比，阴道扩张联合卵巢切除的建模方式更可行，并且模型稳定、成模率高。进一步本研究通过利用的建立的FGSAD大鼠模型，观察到阴道黏膜下微血管显著下降，同时与其他组相比血管相关蛋白VEGF和vWF表达量显著最低，MMP-9蛋白表达量显著升高。通过阻断阴部内动脉及其阴道血供属支，模拟阴道血流阻断模型。模型组动情周期出现了紊乱，阴道的重量出现了下降。阴道血流阻断后阴道组织出现纤维化，黏膜微血管数量显著减少。与血管生成相关的蛋白质如VEGF、ERK和p-ERK的水平在模型组也出现了显著降低。因此，阴道扩张联合卵巢去除的造模方式最符合人类FGSAD的病理生理机制，可作为FGSAD的标准动物模型。FGSAD中阴道血流减少的致病机制与血管生成相关的VEGF/ERK信号通路有关。.2、调查新冠疫情期间居家隔离生活对中国部分地区女性性生活及性行为的影响及其因素，并分析疫情期间女性性功能障碍（FSD）的现状。本次调查经筛选回收完整问卷678份。在疫情期间FSD评分(FSFI)为21.98±6.38，FSD的发生率为61.9%，上海、南京、宁夏三个地区FSD的发病率为60.6%，75.2%和52.2%。FSFI评分频率和其他具体项目(欲望、兴奋、润滑、高潮、满足感和疼痛)变化显著。自慰人群中FSD的总体频率为34.4%，低于有配偶性行为的FSD的频率(60.1%)。疫情流行期间FSD的发生与不同的年龄阶段，更年期，分娩方式，焦虑和抑郁程度等生活方式有关。新冠大流行对人们的精神生活和性生活产生了巨大影响，其由与个人和环境相关的多个不同变量引起的。我们应该在新冠疫情中重视性健康的重要性，拥有和谐稳定的性生活将有助于我们度过孤独的无聊生活。