血清MMP-3和bFGF水平与子宫内膜息肉切除术后宫腔粘连的关系  

Relationship between serum matrix metalloproteinase-3,basic fibroblast growth factor levels and uterine adhesion after endometrial polypectomy

作　　者：王春香 李晓梅 赵会娟 申林林 张亚琴 WANG Chunxiang;LI Xiaomei;ZHAO Huijuan;SHEN Linlin;ZHANG Yaqin(Department of Reproductive Medicine,Hengshui Maternal and Child Health Hospital,Hengshui 053000,Hebei,China;Department of Medicine,Hengshui Maternal and Child Health Hospital,Hengshui 053000,Hebei,China;Department of the Second Obstetrics and Gynecology,Shijiazhuang Maternal and Child Health Hospital,Shijiazhuang 050000,Hebei,China;Department of the Third Obstetrics and Gynecology,Shijiazhuang Maternal and Child Health Hospital,Shijiazhuang 050000,Hebei,China)

机构地区：[1]衡水市妇幼保健院生殖医学科,河北衡水053000 [2]衡水市妇幼保健院医务科,河北衡水053000 [3]石家庄市妇幼保健院妇二科,石家庄050000 [4]石家庄市妇幼保健院妇三科,石家庄050000

出　　处：《中国性科学》2024年第11期61-65,共5页Chinese Journal of Human Sexuality

基　　金：河北省卫生健康委科研计划项目(20231637)。

摘　　要：目的探讨血清基质金属蛋白酶(MMP)-3和碱性成纤维细胞生长因子(bFGF)水平与子宫内膜息肉切除术后宫腔粘连的关系。方法选取2019年8月至2021年8月衡水市妇幼保健院收治的144例行宫腔镜子宫内膜息肉切除术患者作为研究对象,进行术后2年随访,根据随访结果分为粘连组(n=64)和非粘连组(n=80)。采用酶联免疫吸附试验法检测血清MMP-3和bFGF水平。比较两组临床资料、血清MMP-3和bFGF水平、不同粘连程度组血清MMP-3和bFGF水平,采用受试者工作特征(ROC)曲线的曲线下面积(AUC)分析血清MMP-3和bFGF水平对子宫内膜息肉切除术后发生宫腔粘连的诊断价值,采用Pearson法分析血清MMP-3和bFGF水平的相关性,采用Logistic回归分析子宫内膜息肉切除术后发生宫腔粘连的影响因素。结果两组有无剖宫产史、刮宫史、盆腔炎史占比及孕次比较,差异具有统计学意义(P<0.05)。粘连组血清bFGF水平高于非粘连组,MMP-3水平低于非粘连组(P<0.05)。重度、中度粘连组bFGF水平均高于轻度粘连组,MMP-3水平均低于轻度粘连组(P<0.05)。血清MMP-3和bFGF两者联合诊断效能高于单独诊断(P<0.05)。子宫内膜息肉切除术后宫腔粘连患者血清MMP-3和bFGF呈负相关(r=-0.464,P<0.05)。盆腔炎史、孕次及血清MMP-3、bFGF水平是子宫内膜息肉切除术后发生宫腔粘连的影响因素(P<0.05)。结论血清MMP-3水平在子宫内膜息肉切除术后宫腔粘连患者中显著升高,bFGF水平显著降低,两者呈负相关,对诊断子宫内膜息肉切除术后宫腔粘连具有一定的诊断效能,两者联合诊断效能高于单一诊断,且bFGF和MMP-3均为子宫内膜息肉切除术后发生宫腔粘连的影响因素。Objective To investigate the relationship between serum levels of matrix metalloproteinase(MMP)-3,basic fibroblast growth factor(bFGF)and uterine adhesion after endometrial polypectomy.Methods,A total of 144 patients who underwent hysteroscopic endometrial polypectomy in Hengshui Maternal and Child Health Hospital from August 2019 to August 2021 were recruited as the study objects and followed up for 2 years after surgery.They were divided into adhesive group(n=64)and non-adhesive group(n=80)based on the follow-up results.Enzyme-linked immunosorbent assay was applied to detect the serum levels of MMP-3 and bFGF.The clinical data,serum MMP-3 and bFGF levels,and serum MMP-3 and bFGF levels in groups with different adhesion degree were compared between the two groups.The diagnostic value of serum MMP-3 and bFGF levels in uterine adhesion after endometrial polypectomy was analyzed by the area under the curve(AUC)of receiver operating characteristic(ROC)curve.Pearson method was used to analyze the correlation between serum MMP-3 and bFGF levels,and Logistic regression was used to analyze the influencing factors of uterine adhesion after endometrial polypectomy.Results There were statistically significant differences in cesarean section history,curettage history,pelvic inflammatory history,and pregnancy between the two groups(P<0.05).The serum bFGF level in the adhesive group was higher than that in the non-adhesive group,and the MMP-3 level was lower than that in the non-adhesive group(P<0.05).The bFGF levels in the severe and moderate adhesion groups were both higher than those in the mild adhesion group,and the MMP-3 levels were lower than those in the mild adhesion group(P<0.05).The combined diagnostic efficacy of serum MMP-3 and bFGF was higher than that of single diagnosis(P<0.05).There was a negative correlation between the serum MMP-3 and bFGF in patients with uterine adhesion after endometrial polypectomy(r=-0.464,P<0.05).Pelvic inflammatory history,pregnancy numbers,serum MMP-3 and bFGF levels were the influe

关 键 词：基质金属蛋白酶-3 碱性成纤维细胞生长因子 子宫内膜息肉切除术 宫腔粘连 

分 类 号：R711[医药卫生—妇产科学]