左炔诺孕酮宫内缓释系统对子宫腺肌病患者体内PGE_2、COX-2水平的影响  

Effect of the levonorgestrel-releasing intrauterine system on the level of PGE_2 and the expression of COX-2 of patients with adenomyosis

作　　者：陈筱筱[1] 傅士龙[2] 崔毓桂[2] 卫红[2] 官兰芳[2] 韩素萍[2] 

机构地区：[1]南京医科大学第二附属医院,南京210009 [2]南京医科大学第一附属医院,南京210009

出　　处：《现代妇产科进展》2014年第9期685-687,共3页Progress in Obstetrics and Gynecology

摘　　要：目的:研究子宫腺肌病患者置左炔诺孕酮宫内缓释系统(LNG-IUS)前后血浆前列腺素E2(PGE2)及子宫内膜组织中环氧化酶2(COX-2)的表达,探索LNG-IUS缓解子宫腺肌病痛经症状的机制。方法:采用视觉模拟评分法(VAS)和口述评分法(VRS)评定患者痛经的程度,ELISA法检测血浆PGE2含量;免疫组化法检测子宫内膜组织中COX-2的表达;Western blot法检测子宫内膜组织中COX-2蛋白含量。结果:放置LNG-IUS后,患者VAS评分及VRS评分均下降(VAS评分:22.96±21.09vs 83.81±9.82,VRS评分:0.67±0.48vs 1.41±0.64)(P<0.05)。置环后血浆PGE2水平较置环前降低[(18.83±23.97)pg/ml vs(5.76±2.62)pg/ml,P<0.05],子宫内膜组织中COX-2表达降低,置环前后COX-2表达阳性率分别为100%和66.7%(P<0.05),置环前后COX-2蛋白表达水平灰度值具有显著差异(1177312.68±356104.82vs 310510.22±215690.66)(P=0.046)。结论:LNG-IUS缓解子宫腺肌病患者痛经症状的机制可能与抑制COX-2合成、降低PGE2水平有关。Objective：To investigate the effect of the levonorgestrel-releasing intrauterine system （LNG-IUS） on the levels of prostaglandin E2（PGE：） in plasma and the expression of cyclooxygenase-2 （COX-2） in endometria of patients with adenomyosis. To explore the mechanism of the LNG-IUS in treating dysmenorrhea of adenomyosis. Methods：We estimate the visual analogue scale （VAS） scores and verbal rating scale （VRS） scores of their dysmenorrhea at baseline. The concentrations of PGE2 in plasm were determined by enzyme linked immunosorbent assay （ELISA）. The expression of COX-2 protein in the endometria was detected with im- munohistochemistry and Western blot. Results：After the insertion of LNG-IUS, the VAS scores fall from （83.81±9.82） to （22.96±21.09）. The VRS scores fall from （1.41±0.64） to （0. 67±0.48 ） （ P〈0.05 ）. The levels of PGE2 decreased from （ 18.83±23.97 ） pg/ml to （5.76 ±2.62） pg/ml（P〈0.05）. The expression of COX-2 were also significantly decreased after the insertion of LNG-IUS（P〈0.05）. The positive expression rate falls from 100% to 66.7% in im- munohistoehemistry（P 〈 0. 05 ）. The gray value falls from （ 1177312. 68± 356104. 82 ） to （310510.22±215690.66） in Western blot （P〈0.05）. Conclusion：The LNG-IUS is effective in treating dysmenorrhea of adenomyosis. It can decrease the levels of PGE2 and the expression of COX-2 in people with adenomyosis, which may have relationship with the dysmenorrhea in adenomyosis.

关 键 词：左炔诺孕酮宫内缓释系统 子宫腺肌病 前列腺素E2 环氧化酶2 

分 类 号：R711.71[医药卫生—妇产科学]