子宫内膜异位症患者慢性盆腔疼痛程度与炎症反应和应激反应相关性研究  

Study on the correlation between the degree of chronic pelvic pain and inflammation and stress in patients with endometriosis

作　　者：何旺丽 汪志霞[1] 黎明 陈丽琴 盖其婷 石中华[2] He Wangli;Wang Zhixia;Li Ming;Chen Liqin;Gai Qiting;Shi Zhonghua(Department of Obstetrics and Gynecology,BenQ Hospital Affiliated to Nanjing Medical University,Nanjing Jiangsu 210019,P.R.China;Department of Obstetrics and Gynecology,Nanjing Maternal and Child Health Hospital Affiliated to Nanjing Medical University,Nanjing Jiangsu 210019,P.R.China)

机构地区：[1]南京医科大学附属明基医院妇产科,江苏南京210019 [2]南京医科大学附属南京妇幼保健院妇产科,江苏南京210019

出　　处：《中国计划生育和妇产科》2021年第12期70-73,共4页Chinese Journal of Family Planning & Gynecotokology

基　　金：南京医科大学科技发展基金项目(项目编号:NMUB2018191);国家自然科学基金资助项目(项目编号:81571458);南京市医学科技发展项目(项目编号:YKK16242)。

摘　　要：目的探讨子宫内膜异位症(endometriosis,EMs)患者慢性盆腔疼痛程度与炎症反应和应激反应的相关性。方法选取2017年5月至2018年11月在南京医科大学附属明基医院就诊的EMs患者98例作为观察组,根据疼痛评分分为轻度组(34例)、中度组(36例)和重度组(28例),另选取40例健康体检女性作为对照组。采用ELISA法测定各组受试者血清中炎症因子肿瘤坏死因子(tumor necrosis factor-α,TNF-α)、白介素6(interleukin-6,IL-6)、白介素8(interleukin-8,IL-8)和单核细胞趋化蛋白-1(monocyte chemotactic protein 1,MCP-1)的含量;比色法测定氧化应激因子丙二醛(malondialdehyde,MDA)、超氧化物歧化酶(superoxide dismutase,SOD)和谷胱甘肽过氧化物酶(glutathione peroxidase,GSH-Px)的表达水平;放射免疫分析法测定应激激素皮质醇(cortisol,Cor)和去甲肾上腺素(norepinephrine,NE)的含量。分析炎症反应和应激反应指标与EMs患者慢性盆腔疼痛程度的相关性。结果与对照组相比,观察组血清TNF-α、IL-6、IL-8、MCP-1和MDA表达水平上升,且其表达水平随着患者疼痛程度升高而上升,差异有统计学意义(P<0.05)。观察组血清SOD、GSH-Px、Cor和NE含量明显低于对照组,且其表达水平随着患者疼痛程度上升而下降(P<0.05)。观察组盆腔疼痛程度与TNF-α、IL-6、IL-8、MCP-1和MDA表达水平均呈正相关,与SOD、GSH-Px、Cor和NE表达水平呈负相关。结论EMs患者血清中炎症因子和应激指标表达发生明显变化,其慢性盆腔疼痛程度与炎症反应和应激反应的过度激活显著相关。Objective To explore the relationship between the degree of chronic pelvic pain and inflammation and stress in patients with endometriosis(EMs).Methods 98 patients with EMs who were treated at BenQ Hospital Affiliated to Nanjing Medical University from May 2017 to November 2018 were selected as the observation group.According to the pain score,they were divided into mild group(34 cases),moderate group(36 cases)and severe group(28 cases),another 40 healthy checkup women were selected as the control group.The ELISA method was used to determine the serum levels of inflammatory factors TNF-α,IL-6,IL-8 and MCP-1;the colorimetric method was used to determine the expression levels of oxidative stress factors MDA,SOD and GSH-Px;radioimmunoassay was used to determine the content of stress hormones Cor and NE.Analyzed the correlation between inflammatory response and stress response indicators and the degree of chronic pelvic pain in patients with EMs.Results Compared with the control group,the serum TNF-α,IL-6,IL-8,MCP-1 and MDA expression levels in the observation group increased,and their expression levels increased with the pain degree of the patients and the differences were statistically significant(P<0.05).The levels of serum SOD,GSH-Px,Cor and NE in the observation group were significantly lower than those in the control group,and their expression levels decreased with the degree of the patient’s pain(P<0.05).The degree of pelvic pain in the observation group was positively correlated with the expression levels of TNF-α,IL-6,IL-8,MCP-1 and MDA,and negatively correlated with the expression levels of SOD,GSH-Px,Cor and NE.Conclusion The expression of inflammatory factors and stress indicators in the serum of EMs patients changes significantly,and the degree of chronic pelvic pain is significantly related to the excessive activation of inflammatory response and stress response.

关 键 词：子宫内膜异位症 慢性盆腔痛 炎症反应 应激反应 

分 类 号：R711.71[医药卫生—妇产科学]