子宫腺肌病神经生长因子蛋白表达水平与盆腔疼痛的发生机制研究

目的:探讨子宫腺肌病神经生长因子(nerve growth factor,NGF)蛋白表达水平与盆腔疼痛的关系。方法:选取因子宫腺肌病行子宫全切除的患者51例,根据疼痛情况分为无痛组(无盆腔疼痛)15例,疼痛组36例;选取同期子宫肌瘤及行子宫切除的宫颈上皮内瘤变患者32例为对照组。无痛组和疼痛组术中取子宫腺肌病病灶,对照组取子宫内膜;免疫组化检测NGF蛋白表达水平,免疫荧光法检测蛋白基因产物(protein gene product,PGP)9.5阳性神经纤维数。结果:疼痛组NGF蛋白表达明显强于无痛组、对照组,差异有统计学意义(P<0.05);无痛组与对照组之间差异无统计学意义(P>0.05)。疼痛组PGP 9.5阳性神经纤维密度明显高于无痛组、对照组,差异有统计学意义(P<0.05);无痛组与对照组之间差异无统计学意义(P>0.05)。子宫腺肌病盆腔重度疼痛者NGF蛋白表达强于轻中度痛和无痛者,PGP 9.5阳性神经密度明显高于轻中度痛和无痛者,差异有统计学意义(P<0.05)。结论:子宫腺肌病NGF蛋白表达水平提升参与盆腔疼痛的发生机制,促进病灶内膜神经纤维植入为其机制之一。

Study on the relationship between the expression level of NGF protein and the mechanism of pelvic pain in patients with uterine gland

Objective:To investigate the relationship between the expression level of nerve growth factor (NGF) protein and the mechanism of pelvic pain in patients with uterine gland disease.Methods:51 patients with total resection of uterine adenomyosis,51 cases,according to the pain points for painless group 15 cases,pain group 36 cases.Selected the same period uterine myoma and uterine resection of cervical intraepithelial neoplasia in patients with 32 cases as the control group.Painless group and pain group take the uterine adenomyosis lesions in surgery,the control group take the endometrium.The expression level of protein was detected by immunohistochemistry,and the number of nerve fibers in the white gene positive product (PGP) was detected by immunofluorescence assay.Resuits:The expression of NGF protein in pain group was significantly stronger than that in painless group and control group,the difference was statistically significant (P ＜ 0.05),there was no significant difference between the painless group and the control group (P ＞0.05).Pain group PGP 9.5 positive nerve fiber density was significantly higher than the painless group and the control group,the difference was statistically significant (P ＜ 0.05),there was no significant difference between the painless group and the control group (P ＞ 0.05).The expression of NGF protein was stronger than that of mild to moderate pain and pain in patients with severe dysmenorrhea,PGP 9.5 positive nerve density was significantly higher than that of mild and moderate pain and painless,the difference was statistically significant (P ＜ 0.05).Conclusions:The level of NGF protein expression in the uterine gland is promoted to participate in the pathogenesis of dysmenorrhea,and promote the mechanism of the insertion of the nerve fiber.