卵巢子宫内膜异位症中Vaspin、Visfatin的表达情况及在预后判断中的价值  

Expression of Vaspin and Visfatin in ovarian endometriosis and their value in prognosis

作　　者：邓凤 易旺军 吴樱 刘洋[1] 陈怡[1] DENG Feng;YI Wangjun;WU Ying;LIU Yang;CHEN Yi(Obstetrics and Gynecology Department,Changsha Third Hospital/Changsha Hospital Affiliated to Hunan University of Traditional Chinese Medicine,Changsha,Hunan 410015,China)

机构地区：[1]长沙市第三医院/湖南中医药大学附属长沙医院妇产科,湖南长沙410015

出　　处：《国际检验医学杂志》2023年第13期1562-1566,1572,共6页International Journal of Laboratory Medicine

基　　金：湖南省自然科学基金项目(2019JJ801112)。

摘　　要：目的探讨卵巢子宫内膜异位症(OEM)患者内脏脂肪特异性丝氨酸蛋白酶抑制剂(Vaspin)、内脂素(Visfatin)的表达情况及在预后判断中的价值。方法将2017年8月至2019年5月该院收治的86例OEM患者纳入研究作为OEM组。根据OEM患者是否发生术后复发,将其分为复发组(32例)和未复发组(54例)。选取同期于该院进行体检的64例健康女性作为对照组。采用酶联免疫吸附法检测血清Vaspin、Visfatin水平。分析患者血清Vaspin、Visfatin水平与美国生殖医学学会(ASRM)分期、痛经严重程度的关系。多因素Logistic回归分析OEM术后复发的危险因素。应用受试者工作特征曲线分析血清Vaspin、Visfatin对OEM术后复发的预测效能。采用Kaplan-Meier法(Log-Rank检验)分析Vaspin、Visfatin表达对OEM患者术后无复发生存的影响。结果OEM组患者血清Vaspin、Visfatin水平分别为(218.01±31.66)、(34.38±6.75)ng/mL,对照组分别为(421.50±50.47)、(11.61±4.50)ng/mL。与对照组比较,OEM组患者血清Vaspin水平较低,Visfatin水平较高,差异均有统计学意义(t=30.254、23.385,P<0.001)。不同ASRM分期的OEM患者间血清Vaspin、Visfatin比较,差异有统计学意义(均P<0.05)。ASRM分期Ⅲ~Ⅳ期、Vaspin水平降低、Visfatin水平升高是OEM患者术后复发的独立危险因素,术后妊娠和术后用药是OEM患者术后复发的保护因素。血清Vaspin、Visfatin单独及联合检测对OEM术后复发诊断的曲线下面积(95%CI)分别为0.890(0.820~0.959)、0.838(0.767~0.908)、0.931(0.878~0.985),联合检测的曲线下面积大于单一指标检测(P<0.05)。Vaspin高表达组和低表达组无复发生存率分别为80.95%(34/42)、45.45%(20/44),Vaspin低表达组累积无复发生存情况差于Vaspin高表达组(Log-Rankχ^(2)=4.079,P=0.041)。Visfatin高表达组和低表达组无复发生存率分别为53.66%(22/41)、71.11%(32/45),Visfatin高表达组累积无复发生存情况差于Visfatin低表达组(Log-Rankχ^(2)=6.601,Objective To investigate the expression and clinical prognostic value of visceral fat-specific serine protease inhibitor(Vaspin)and Visfatin in patients with ovarian endometriosis(OEM).Methods A total of 86 OEM patients admitted to the hospital from August 2017 to May 2019 were enrolled in the study as the OEM group.According to whether or not OEM patients had recurrence,they were divided into the recurrence group(32 cases)and the non-recurrence group(54 cases).Sixty-four healthy women who underwent physical examination during the same period were enrolled as the control group.Serum Vaspin and isfatin levels were detected by enzyme-linked immunosorbent assay.The relationship between serum Vaspin and Visfatin levels and ASRM stage and the severity of dysmenorrhea were analyzed.The risk factors of recurrence after OEM operation were analyzed by multivariate Logistic regression.The predictive efficacy of serum Vaspin and Visfatin on postoperative recurrence of OEM was analyzed by subject operation characteristic curve.Kaplan-Meier method(Log-Rank test)was used to analyze the effect of Vaspin and Visfatin expression on postoperative relapse-free survival of OEM patients.Results Serum Vaspin and Visfatin levels in OEM group were(218.01±31.66)and(34.38±6.75)ng/mL,respectively,while those in control group were(421.50±50.47)and(11.61±4.50)ng/mL,respectively.Compared with control group,serum Vaspin level in OEM group was lower and Visfatin level was higher,the differences were statistically significant(t=30.254,23.385,P<0.001).There were significant differences in serum Vaspin and Visfatin among OEM patients with different ASRM stages(all P<0.05).ASRM stageⅢtoⅣ,decreased Vaspin level and increased Visfatin level were independent risk factors for postoperative recurrence in OEM patients,and postoperative pregnancy and postoperative medication were protective factors for postoperative recurrence in OEM patients.The area under the curve(95%CI)of serum Vaspin and Visfatin used alone and in combination for the diagnosi

关 键 词：子宫内膜异位症 内脏脂肪特异性丝氨酸蛋白酶抑制剂 内脂素 预后 

分 类 号：R446.11[医药卫生—诊断学]