子宫内膜异位症在位内膜神经纤维分布与疼痛关系的研究  

Relationship between Nerve Fibers Distribution in Eutopic Endometrium and the Pain Symptom in Endometriosis

作　　者：刘莉娜[1] 姜盟[1] 王广兰[1] 王化丽[1] 

机构地区：[1]辽宁省大连市妇产医院,辽宁大连116033

出　　处：《实用妇产科杂志》2012年第8期654-657,共4页Journal of Practical Obstetrics and Gynecology

基　　金：辽宁省大连市科技计划项目(编号:20110659)

摘　　要：目的:检测子宫内膜异位症(EMT)在位内膜中的神经纤维蛋白基因产物9.5(PGP9.5)、P物质(SP)和神经生长因子(NGF)的分布,探讨其与疼痛的关系。方法:选择EMT患者45例,按视觉模拟评分(VAS)法将患者分为EMT疼痛组(24例)和EMT无痛组(21例),其中轻度疼痛者4例,中度疼痛者7例,重度疼痛者13例;另选择同期患子宫肌瘤住院的患者25例作为对照组。应用免疫组化SP方法分别检测子宫内膜的PGP9.5标记的神经纤维密度(条/mm2)和SP、NGF的平均光密度(OD)值,并与VAS评分进行相关性分析。结果:EMT疼痛组中PGP9.5的密度和SP、NGF的OD值均高于EMT无痛组和对照组(P<0.05)。EMT重度疼痛组中PGP9.5的密度和SP、NGF的OD值明显高于轻度和中度疼痛组(P<0.05)。同时,EMT疼痛组中PGP9.5的密度和SP、NGF的OD值与患者的VAS疼痛评分呈正相关(r=0.745,0.624,0.628;P<0.05)。结论:EMT患者在位内膜存在神经纤维的异常分布。EMT中神经纤维的表达与疼痛的严重程度有关,神经纤维的异常高表达可能是EMT患者疼痛的原因之一。Objective：To investigate the Iocalizations of PGP9.5,SP and NGF in eutopic endometrium of endometriosis, and to explore the relationship between the distribution of endometrial nerve fibers and the pain associated with endometriosis. Methods： Forty-five endometriosis patients were divided into 24 cases with pain, which included 4 cases with mild pain ,7 cases with moderate pain and 13 cases with severe pain, 21 cases without pain according to the visual analogue scale method （VAS）. The density of PGP9.5-nerve fibers, and the average optical density of SP and NGF were detected by immunohistochemical staining, and their correlation with scores of the VAS were also analyzed. Results： The density of PGP9.5-nerve fibers, and the average optical density of SP and NGF in pain group of endometriosis were significantly higher than those in painless group and in control group （P 〈0.05）. The density of PGP9.5-nerve fibers, and the aver- age optical density of SP and NGF in severe pain group were significantly higher than those in mild pain group and moderate pain group （ P 〈 0.05）, and both of them were significantly correlated with scores of VAS （ r = 0.745,0. 624,0. 628, respectively; P 〈 0.05 ）. Conclusions： The distribution of nerve fibers in ec- topic endometrium of endometriosis patients is abormal. The expression of nerve fibers is related to the pain severity, and abnormal high expression of nerve fibers was one of the reseasons causing the pain in endo- metriosis.

关 键 词：子宫内膜异位症 神经纤维 疼痛 免疫组化 

分 类 号：R711.71[医药卫生—妇产科学]