腹腔局部细胞因子在子宫内膜异位症和子宫腺肌病致不孕中的作用  

The Role of Cytokines in Peritoneal Fluid of Patients with Endometriosis and Adenomyosis Associated Infertility

作　　者：陈淑芳[1] 唐振华[1] 李玉宏[1] 奚吉[1] 梁艳[1] 杲丽[1] 郭玉娜[1] 钱俊[1] 杨颖[2] 张健[1] 

机构地区：[1]上海交通大学医学院附属国际和平妇幼保健院,上海200030 [2]上海市血液中心,上海200051

出　　处：《实用妇产科杂志》2011年第7期507-511,共5页Journal of Practical Obstetrics and Gynecology

基　　金：上海市卫生局资助项目(编号:2007164);上海市自然科学基金资助项目(编号:08ZR1421200)

摘　　要：目的:通过测定子宫内膜异位症(EMT)和子宫腺肌病在不孕症患者腹腔液中细胞因子的含量,探讨腹腔局部细胞因子在EMT和子宫腺肌病相关不孕发病中的作用。方法:选取2008年1月至2009年12月疑似EMT和子宫腺肌病合并不孕行腹腔镜手术者86例,采用Luminex液相蛋白芯片技术,检测所有研究者腹腔液干扰素-γ(IFN-γ)、肿瘤坏死因子-α(TNF-α)、血管内皮生长因子(VEGF)及白细胞介素(IL)-6、10、17的含量,并分析细胞因子含量与EMT分期的关系。结果:按手术与病理结果最终纳入病例共57例,分为4组:Ⅰ～Ⅱ期EMT 13例(EMT轻度组)、Ⅲ～Ⅳ期EMT 14例(EMT重度组)、子宫腺肌病13例(子宫腺肌病组)、EMT与子宫腺肌病并存17例(并存组)。正常盆腔26例(对照组)。除IFN-γ外,TNF-α、IL-6、IL-10、IL-17、VEGF 5种细胞因子在5组间比较差异均有统计学意义(P<0.05)。5种细胞因子在组间两两比较:①EMT轻度组及重度组均显著高于对照组(P<0.05),而EMT轻、重度组之间差异无统计学意义(P>0.05);②子宫腺肌病组5种因子均与对照组相似(P>0.05),TNF-α、IL-6、IL-17 3种因子低于EMT轻度组及重度组(P<0.05),VEGF低于重度组(P<0.05);③并存组细胞因子含量明显高于子宫腺肌病组和对照组(P<0.05),而与EMT轻、重度组分别比较差异无统计学意义(P>0.05)。结论:EMT患者盆腔局部细胞因子的异常产生导致盆腔内环境的改变可能干扰正常生殖过程。子宫腺肌病不孕的原因可能有别于EMT,与盆腔局部内环境细胞因子无关。Objective：To analyze the levels of cytokines in peritoneal fluid of patients with endometriosis and adenomyosis associated infertility to investigate the role of cytokines in the pathogenesis of endometriosis and adenomyosis associated infertility.Methods：86 patients,who underwent laparoscopy for confirmation of endometriosis and adenomyosis associated infertility from Jan.2008 to Dec.2009,were recuited in this study.The concentrations of cytokines in peritoneal fluid including interferon（IFN）-γ、tumour necrosis factor（TNF）-α、vascular endothelial growth factor（VEGF） and interleukin（IL）-6、10、17 were measured by luminex multiplex analysis and the correlations between these cytokines and stages of disease were analyzed.Results：57 patients,confirmed by surgery and histology,were acturally selected in the study.They were divided into four groups： 13 cases with stage Ⅰ～Ⅱ endometriosis（mild group） 、14 cases with stage Ⅲ～Ⅳ endometriosis（severe group）、13 cases with adenomyosis（adenomyosis group）、17 cases with endometriosis and adenomyosis（coexisting group） and 26 cases of normal pelvis in control group.Except IFN-γ,the levels of the other five cytokines（TNF-α、IL-6、IL-10、IL-17、VEGF） in five groups were significantly different.The results of mutual comparison among these five cytokines： ①the levels in mild and severe group were significantly higher than those in control group（P0.05）,while there were no differences between mild and severe group（P0.05）;②the levels of the five cytokines in adenomyosis group were similar to those in control group（P0.05）.the levels of TNF-α、IL-6、IL-17 were lower than those in mild and severe group（P0.05）,the level of VEGF was lower than that in severe group（P0.05）;③the levels of the five cytokines in coexisting group were significantly higher than those in adenomyosis and control group（P0.05）,while there were no significant differences among coexisting、mild and severe group（P

关 键 词：子宫内膜异位症 子宫腺肌病 不孕症 细胞因子 Luminex液相蛋白芯片技术 

分 类 号：R711.71[医药卫生—妇产科学]