人工周期对宫腔粘连患者子宫内膜中MMP-9和TGF-β1表达的影响  

Effect of artificial cycle on expression of MMP-9 and TGF-β1 of endometria in patients with uterine adhesion

作　　者：何英新[1,2] 唐彩霞[1] 刘珏[2] 李梅清[2] 谢春花[2] 

机构地区：[1]南华大学附属南华医院妇产科,湖南衡阳421002 [2]南华大学附属第二医院妇产科,湖南衡阳421001

出　　处：《重庆医学》2014年第2期167-169,172,共4页Chongqing medicine

基　　金：湖南省卫生厅科研基金(c2008-013)

摘　　要：目的探讨人工周期对宫腔粘连患者粘连分解术预后的影响及机制。方法 80例宫腔粘连患者随机分为观察组和对照组。观察组行宫腔镜宫腔粘连分解术(TCRA),术后人工周期连续治疗3个月:每日服用戊酸雌二醇(每次9mg,每天1次)21d,后7d加服醋酸甲羟孕酮(每次10mg,每天1次),停药7d为1个周期;对照组直接施行TCRA,3个月后复查。采用酶联免疫法测定血清6项性激素,包括卵泡刺激素(FSH)、黄体生成素(LH)、雌激素(E2)、催乳素(PRL)、孕酮(P)及睾酮(T)。实时定量PCR和蛋白质印迹法检测子宫内膜中基质金属蛋白酶-9(MMP-9)和转化生长因子-β1(TGF-β1)的表达。结果与对照组相比较,人工周期治疗结合手术治疗显著提高了轻中度宫腔粘连患者TCRA术的治疗有效率(P<0.05);对照组和观察组患者血清中FSH、LH、E2、PRL、P和T等性激素水平差异无统计学意义(均P>0.05);人工周期治疗显著性改善了TCRA术后宫腔粘连程度,增加MMP-9的表达并降低TGF-β1的表达。结论人工周期改善了宫腔粘连患者TCRA术的预后效果,其机制可能与人工周期增加MMP-9的表达和降低TGF-β1的表达有关。Objective To investigate the effect of the artificial cycle on the prognosis after transcervica] resection of adhesion （TCRA） and its mechanism. Methods 80 patients with intrauterine adhesion were randomly divided into the observation group and the control group. The observation group were performed TRCA and postoperative artificial cycle for successive 3 months：oral estradiol valerate（9 mg once daily） for 21 d, adding oral medroxyprofgesterone acetate（ 10 mg once dialy） on 15 d, then the medication discontinuation for 7 d,which was taken as 1 cycle;the control group received only TCRA. The re-examination was performed after 3 months. The levels of follicle stimulating hormone（FSH） ,luteinizing hormone（LH） ,estradiol（Ez ） ,prolactin（PRL） ,progesterone （P） and testosterone（T） were examined by ELISA after TCRA three months. The expression of MMP-9 and TGF-β1 in adhesive endometrium were detected by real-time PCR and Western blot. Results Compared with the control group, the artificial cycle thera- py combined with the operation could significantly increase the effective rate of TCRA for treating mild and moderate intrauterine adhesion （P〈0.05） ;the seum levels of FSH, LH, E2, PRL, P and T had no statistical differences between the observation group and the control group（P〈0.05）;the artificial cycle significantly improved the adhesive degree of intrauterine adhesion, increased the MMP-9 expression and decreased the TGF-β1 expression. Conclusion Artificial cycle could improve the degree of uterine cavity ad- hesion after TCRA,which the mechanism might be related to the increase of MMP-9 expression and decrease of TGF-β1 expression.

关 键 词：雌激素类 子宫疾病 黏连 周期性 基质金属蛋白酶9 转化生长因子-β1 

分 类 号：R713[医药卫生—妇产科学]