血清PAI-1、Flk-1与深部浸润型子宫内膜异位症及其腹腔镜保守治疗效果的关系研究  

Study on the relationship between serum PAI-1,Flk-1 and deep infiltrating endometriosis and the effect of conservative laparoscopic treatment

作　　者：赵冰 赵萌 黄丹青 ZHAO Bing;ZHAO Meng;HUANG Dan-qing(Department of Gynecology,Zibo Maternal and Child Health Hospital,Zibo Shandong 255000,China)

机构地区：[1]淄博市妇幼保健院妇科,山东淄博255000

出　　处：《临床和实验医学杂志》2024年第11期1188-1192,共5页Journal of Clinical and Experimental Medicine

基　　金：山东省医药卫生科技发展计划项目(编号:202005010441)。

摘　　要：目的 分析血清纤溶酶原激活物抑制物(PAI)-1、胎肝激酶-1(Flk-1)与深部浸润型子宫内膜异位症(DIE)及其腹腔镜保守治疗效果的关系。方法 回顾性选择自2020年1月至2022年11月在淄博市妇幼保健院行腹腔镜保守治疗的120例子宫内膜异位症患者作为研究对象。根据是否为DIE分为DIE组(n=48)和非DIE组(n=72)。比较DIE组与非DIE组的年龄、病程、癌抗原125(CA125)、美国生育学会修正分期法(r-AFS)评分、血清PAI-1及Flk-1表达水平;分析DIE患者血清PAI-1、Flk-1表达水平与病程、CA125、r-AFS评分的关系;采用受试者工作特征(ROC)曲线评价血清PAI-1、Flk-1对腹腔镜保守治疗后病情复发的预测效能。结果 DIE组病程为(7.42±4.56)年,长于非DIE组[(5.12±2.18)年],CA125水平、r-AFS评分及PAI-1、Flk-1表达水平分别为(61.42±8.75) kU/L、(47.57±6.08)分、(231.47±46.87) mg/L、(52.42±10.17) ng/mL,均高于非DIE组[(43.08±4.67) kU/L、(34.25±4.26)分、(156.24±16.93) mg/L、(21.65±4.53) ng/mL],差异均有统计学意义(P<0.05)。经多因素Logistic回归分析,病程、CA125、r-AFS评分、PAI-1、Flk-1均是DIE的独立危险因素(P<0.05)。经Pearson相关性分析,DIE患者血清PAI-1、Flk-1表达水平均与病程、CA125水平、r-AFS评分呈正相关(P<0.05)。在48例DIE患者中,腹腔镜保守治疗无效6例,占12.50%;无效患者血清PAI-1、Flk-1表达水平均高于有效患者,差异均有统计学意义(P<0.05)。经ROC曲线分析结果显示,血清PAI-1联合Flk-1预测DIE患者腹腔镜保守治疗后病情复发的曲线下面积(AUC)为0.931。结论 血清PAI-1、Flk-1与DIE严重程度密切相关,联合应用可提高对腹腔镜保守治疗后病情复发的预测效能。Objective To analyze the relationship between serum plasminogen activator inhibitor(PAI)-1,fetal liver kinase(Flk)-1 and deep infiltrating endometriosis(DIE)and the effect of conservative laparoscopic treatment.Methods One hundred and twenty patients with endometriosis who underwent laparoscopic conservative treatment at Zibo Maternal and Child Health Hospital from January 2020 to November 2022 were retrospectively selected as the study subjects.According to whether or not to DIE,they were divided into the DIE group(n=48)and the non DIE group(n=72).Age,course of disease,cancer antigen 125(CA125),Revised American Fertility Society(r-AFS)score,the expression levels of serum PAI-1 and Flk-1 were compared between the DIE group and the non DIE group.And the relationship between the expression levels of serum PAI-1 and Flk-1 and the course of disease,CA125,r-AFS score were analyzed.The predictive efficacy of serum PAI-1 and Flk-1 for disease recurrence after laparoscopic conservative treatment was evaluated using receiver operating characteristic(ROC)curve.Results The course of disease in the DIE group was(7.42±4.56)years,which was longer than that in the non DIE group[(5.12±2.18)years],the levels of CA125,r-AFS score,the expression levels of serum PAI-1 and Flk-1 were(61.42±8.75)kU/L,(47.57±6.08)points,(231.47±46.87)mg/L,and(52.42±10.17)ng/L,respectively,which were higher than those in the non DIE group[(43.08±4.67)kU/L,(34.25±4.26)points,(156.24±16.93)mg/L,(21.65±4.53)ng/mL],the differences were statistically significant(P<0.05).Multivariate Logistic regression analysis showed that the course of disease,CA125,r-AFS score,the expression levels of serum PAI-1 and Flk-1 were independent risk factors for DIE(P<0.05).Pearson correlation analysis showed that the expression levels of PAI-1 and Flk-1 in serum of DIE patients were positively correlated with the disease course,CA125 level and r-AFS score(P<0.05).In 48 cases of DIE patients,6 cases of laparoscopic conservative treatment was invalid,accounted for 12.50

关 键 词：子宫内膜异位症 纤溶酶原激活物抑制物-1 腹腔镜 深部浸润型 胎肝激酶-1 

分 类 号：R711.71[医药卫生—妇产科学]