基质金属蛋白酶在子宫内膜异位症患者中的表达水平及在盆腔粘连中的作用

目的分析基质金属蛋白酶(MMPs)在子宫内膜异位症患者中的表达水平及在盆腔粘连中的作用。方法选取2017年1月-2018年12月在温州市人民医院进行腹腔镜手术的60例子宫内膜异位症患者为观察组,选取同期进行腹腔镜手术的30例非子宫内膜异位症患者为对照组。观察组根据术中盆腔粘连程度分为1组(无或仅有轻度盆腔粘连,子宫内膜异位症Ⅰ~Ⅱ期,24例)和2组(中重度盆腔粘连,子宫内膜异位症Ⅲ~Ⅳ期,36例)。采集3组腹腔液和血清,采用ELISA法检测腹腔液及血清基质金属蛋白酶-2 (MMP-2)、基质金属蛋白酶-3 (MMP-3)、基质金属蛋白酶-7 (MMP-7),血清雌二醇(E2)、黄体生成素(LH)、孕酮(P)、卵泡刺激素(FSH),白细胞介素-6 (IL-6)、白细胞介素-8 (IL-8)、肿瘤坏死因子-α(TNF-α)、C-反应蛋白(CRP)水平。结果 1组腹腔液MMP-2、MMP-3、MMP-7水平显著高于对照组,差异有统计学意义(均P<0. 05),2组腹腔液MMP-2、MMP-3、MMP-7水平显著高于1组(均P<0. 05)。1组血清FSH、LH水平显著高于对照组(均P<0. 05),2组血清FSH、LH水平显著高于1组(均P <0. 05)。1组血清E2、P水平显著低于对照组(均P<0. 05),2组血清E2、P水平显著低于1组(均P<0. 05)。1组血清IL-6、IL-8、TNF-α水平显著高于对照组(均P<0. 05),2组血清IL-6、IL-8、TNF-α水平显著高于1组(均P<0. 05)。结论子宫内膜异位症患者腹腔液中MMPs水平升高,可能与盆腔粘连的发生及严重程度相关。

Expression levels of matrix metalloproteinases in patients with endometriosis and the role in pelvic adhesion

Objective To analyze the expression levels of matrix metalloproteinases( MMPs) in patients with endometriosis and the role in pelvic adhesion. Methods Sixty patients with endometriosis treated by laparoscopic surgery in Wenzhou People’s Hospital from January 2017 to December 2018 were selected as observation group,30 patients without endometriosis treated by laparoscopic surgery in the hospital during the same period were selected as control group. The patients in observation group were divided into one group( without or with mild pelvic adhesion,endometriosis stage Ⅰ-Ⅱ,24 patients) and two group( with moderate or severe pelvic adhesion,endometriosis stageⅢ-Ⅳ,36 patients). Peritoneal fluid and serum samples were obtained in the three groups,ELISA was used to detect the levels of metalloproteinase-2( MMP-2),metalloproteinase-3( MMP-3),metalloproteinase-7( MMP-7),estradiol( E2),luteinizing hormone( LH),progesterone( P),follicle-stimulating hormone( FSH),interleukin-6( IL-6),interleukin-8( IL-8),tumor necrosis factor-α( TNF-α),C-reactive protein( CRP) in peritoneal fluid and serum. Results The levels of MMP-2,MMP-3,and MMP-7 in peritoneal fluid of one group were statistically significantly higher than those in control group( P<0. 05),the levels of MMP-2,MMP-3,and MMP-7 in peritoneal fluid of two group were statistically significantly higher than those in one group( P<0. 05). The levels of serum FSH and LH in one group were statistically significantly higher than those in control group( P<0. 05),the levels of serum FSH and LH in two group were statistically significantly higher than those in one group( P<0. 05). The levels of serum E2 and P in one group were statistically significantly lower than those in control group( P<0. 05),the levels of serum E2 and P in two group were statistically significantly lower than those in one group( P<0. 05). The levels of serum IL-6,IL-8,and TNF-α in one group were statistically significantly higher than those in control group( P<0. 05),the levels of serum IL-6,IL-8,and TNF-α in two group were statistically significantly higher than those in one group( P<0. 05). Conclusion The expression levels of MMPs in peritoneal fluid of patients with endometriosis are high,which may be related to the occurrence and severity of pelvic adhesion.