子宫内膜异位症患者细胞因子表达及与盆腔粘连的相关性研究

摘要

目的：探讨细胞因子TNF-α、IL-6与IL-8在子宫内膜异位症（内异症）的表达及其与盆腔粘连程度的相关性。方法选取子宫内膜异位症患者50例，采用ELISA法分别测定手术前血清、术中腹腔液及术后3个月血清标本TNF-α、IL-6、IL-8含量，并分析与粘连的相关性。结果50例内异症患者中，41例（80.2%）患者合并不同程度的盆腔粘连，内异症患者血清、腹腔液中TNF-α、 IL-6及IL-8显著高于对照组(P<0.05)。内异症Ⅲ～Ⅳ期期患者腹腔液中TNF-α、 IL-6及IL-8的水平显著高于Ⅰ~Ⅱ期，Ⅰ~Ⅱ期Ⅲ~Ⅳ期期患者TNF-α水平显著高于对照组(P<0.05)；术后3个月血清TNF-α、 IL-6及IL-8较术前明显下降（P<0.05）。盆腔粘连程度与腹腔液IL-6、 IL-8、TNF-α均呈正相关（r=0.457， r=0.336， r=0.263， P<0.05）；术前血清细胞因子除IL-8（r=0.135， P>0.05）， TNF-α、 IL-6与粘连呈正相关（r=0.521， r=0.470， P<0.05）。结论细胞因子TNF-α、 IL-6及IL-8与内异症临床分期和治疗疗效密切相关，检测TNF-α、 IL-6及IL-8患者血清的变化，可作为子宫内膜异位症术前评估、疗效评价、复发的重要指标。%Objective To investigate the expression of cytokines TNF-ɑ, IL-6 and IL-8 in endometriosis and its correlation with the degree of pelvic adhesions. Methods 50 patients with endometriosis were selected. The TNF-ɑ, IL-6, IL-8 in serum before operation and 3 months after operation and in peritoneal fluid got intra-operation were detected by ELISA. The correlation with adhesions analyzed. Results 41 cases (80.2%) had different degree of pelvic adhesions, and TNF-ɑ, IL-6 and IL-8 in serum and peritoneal fluid were significantly higher than those in the control group (P<0.05). TNF-alpha, IL-6 and IL-8 in peritoneal fluid in patients with stage Ⅲ~Ⅳ was significantly higher than in those with Ⅰ~Ⅱ stage. The TNF-ɑin patients with stage Ⅰ~Ⅱwas significantly higher than those in the control group (P<0.05);TNF-ɑ, IL-6 and IL-8 in serum 3 months after operation were significantly decreased compared to those before operation ( P<0.05). Pelvic adhesion degree and IL-6, IL-8, TNF-ɑin peritoneal fluid were positively correlated (r=0.457, r=0.336, r=0.263, P<0.05);preoperative serum cytokines except IL-8 (r=0.135, P>0.05), TNF-ɑ, IL-6 was positively associated with adhesions (r=0.521, r=0.470, P<0.05). Conlusion Cytokines TNF-ɑ, IL-6 and IL-8 were closely related to the clinical stage and therapeutic efficacy in the treatment of endometriosis. The change of TNF-ɑ, IL-6 and IL-8 in endometriosis was an important index to preoperative evaluation, therapeutic evaluation and recurrence.