宫腔粘连患者子宫内膜厚度及相关因子变化在宫腔镜手术联合激素治疗中的临床意义  

Clinical significance of changes in endometrial thickness and related factors in patients with intrauterine adhesions in the effet of hysteroscopic surgery combined wth hormone therapy

作　　者：石榴 何美芳 文玲 周娟 孔慧祥 SHI Liu;HE Meifang;WEN Ling;ZHOU Juan;KONG Huixiang(Department of Genera,Gynecoogy and Gynecoogy and,Oncology,Zhuzhou Maternal and Child Health Hospital,Zhuzhou 412000,Hunan,China;Department of Reproduction,Zhuzhou Maternal and Child Health Hospital,Zhuzhou 412000,Hunan,China;Department of Pathology,Zhuzhou Maternal and Child Health Hospital,Zhuzhou 412000,Hunan,China)

机构地区：[1]株洲市妇幼保健院普妇与妇瘤科,湖南株洲412000 [2]株洲市妇幼保健院生殖科,湖南株洲412000 [3]株洲市妇幼保健院病理科,湖南株洲412000

出　　处：《中国性科学》2023年第12期73-76,共4页Chinese Journal of Human Sexuality

基　　金：株洲市科技计划项目(2020-010)。

摘　　要：目的探讨宫腔粘连患者宫腔镜手术联合激素治疗后子宫内膜厚度和相关因子表达情况变化。方法选取2020年1月至12月湖南省株洲市妇幼保健院收治的100例中重度宫腔粘连患者作为研究对象。所有患者在宫腔镜下粘连分离术后给予人工周期治疗。连续治疗3个月。统计治疗前、治疗3个月后经量改善情况及子宫内膜形态变化,统计治疗前、治疗3个月后血清及宫腔粘连组织周围的内膜中细胞外基质金属蛋白酶诱导因子(HAb18G)、转录调节因子叉头框F2(FoxF2)、转化生长因子-β1(TGF-β1)、雌激素受体(ER)、结缔组织生长因子(CTGF)、胰岛素样生长因子-1(IGF-1)、血管内皮生长因子(VEGF)水平变化。结果与治疗前比较,治疗3个月后,患者月经量、子宫内膜腺体数增多,子宫内膜厚度增厚,子宫内膜纤维化面积比、血清及宫腔粘连组织周围的内膜中HAb18G、FoxF2、TGF-β1、CTGF、VEGF及IGF-1表达降低,ER升高,差异具有统计学意义(P<0.05)。结论宫腔粘连患者子宫内膜状态及月经量异常,伴有子宫内膜纤维化的发生,而宫腔粘连的发生发展可能与HAb18G、FoxF2、ER、TGF-β1、CTGF、VEGF及IGF-1的异常表达有关,临床可据此对宫腔粘连进行早期预测及预防,并评估其临床治疗效果。Objective To investigate the changes of endometrial thickness and the expression of related factors in patients with intrauterine adhesions after hysteroscopic surgery combined with hormone therapy.Methods A total of 100 patients with moderate and severe intrauterine adhesions admitted to Zhuzhou Maternal and Child Health Hospital from January to December 2020 were selected as the study subjects.All patients were given artificial cycle treatment after hysteroscopic adhesion separation.The patients were treated continuously for 3 months.The improvement of menstruation and endometrial morphology before and after 3 months of treatment,and the changes in levels of serum and in endometrium around uterine cavity adhesion tissue extracellular matrix metalloproteinase inducer(HAb18G),transcription regulator forkhead box F2(FoxF2),transforming growth factor-β1(TGF-β1),estrogen receptor(ER),connective tissue growth factor(CTGF),insulin-like growth factor-1(IGF-1),vascular endothelial growth factor(VEGF)before and after 3 months of treatment were measured.Results Compared with before treatment,after 3 months of treatment,the amount of menstruation and the number of endometrial glands count increased,the thickness of endometrium was thicker,endometrial fibrosis area ratio,the levels of serum and in endometrium around uterine cavity adhesion tissue HAb18G,rate of FoxF2,TGF-β1,CTGF,VEGF and IGF-1 decreased,the ER increased(P<0.05).Conclusions The endometrial status and menstrual volume of patients with uterine adhesion were abnormal,accompanied by the occurrence of endometrial fibrosis.The occurrence and development of intrauterine adhesions may be related to the abnormal expression of HAb18G,FoxF2,ER,TGF-β1,CTGF,VEGF and IGF-1.According to this,the early prediction and prevention of uterine cavity adhesion could be carried out and the clinical treatment effect could be evaluated.

关 键 词：宫腔粘连 细胞外基质金属蛋白酶诱导因子 转录调节因子叉头框F2 转化生长因子-β1 雌激素受体 结缔组织生长因子 胰岛素样生长因子-1 血管内皮生长因子 

分 类 号：R711[医药卫生—妇产科学]