放置IUD出血子宫内膜中血管内皮生长因子及CD_(34)含量的研究

目的:探讨上环出血子宫内膜组织中血管内皮生长因子(VEGF)及内皮细胞的CD34的含量变化及意义。方法:利用免疫组织化学方法和计算机图像分析技术,对三组受试者子宫内膜中VEGF及CD34进行检测。Ⅰ组为置IUD后有异常子宫出血妇女30例,其中金属“O”型环15例,“T”型环15例。Ⅱ组为置IUD后月经周期正常的妇女16例,其中金属“O”型环8例,“T”型环8例。Ⅲ组为无置器月经周期正常的妇女15例。结果:①VEGFⅠ组、Ⅱ组、Ⅲ组子宫内膜腺上皮阳性面积比分别为(3.99±0.15)%,(45.27±0.43)%,(45.36±0.56)%,Ⅰ组和Ⅱ组、Ⅲ组间子宫内膜腺上皮表达差异有显著性(P<0.05);②CD34标记的MVD在Ⅰ组、Ⅱ组、Ⅲ组的值分别为4.67±3.51、18.17±2.43、19.65±4.03,Ⅰ组明显低于Ⅱ、Ⅲ组(P<0.05),而Ⅱ、Ⅲ组间差异无显著性。金属“O”型环和“T”型环在Ⅰ组内无显著性差异(P>0.05)。结论:①VEGF及CD34在上环出血的子宫内膜中表达均下降,影响受损伤的子宫内膜血管的再生修复能力,引起IUD出血;②在放置金属“O”型环与“T”型环的子宫内膜中VEGF、CD34的表达无差异性。

The Expression and Significance of Vascular Endothelial Growth Factor and CD34 in Endometrium Bleeding Induced by Intrauterine Device

Objective:To study the expression and significance of VEGF and CD34 in endometrium bleeding induced by Intrauterine Device(IUD).Methods:With the help of hysteroscope technique and utilizing immunohistochemical(IHC) method and computer image analysis technique to test the expression of VEGF and CD_(34) in endometrium group : 30 patients were abnormal uterus bleeding after inserting IUD,including 15 patients with metal "O" ring and 15 patients with "T" ring.Ⅱgroup : 16 patients were normal menstrual cycle after inserting IUD,8 patients with metal "O" ring and 8 patients with "T" ring.Ⅲ group: 15 patients were normal menstrual cycle without IUD.Results:VEGF:The glandular epithelium expressive ratio of endometrium positive area among Ⅰ,Ⅱ and Ⅲgroup respectively was 3.99±0.15%、45.27±0.43%、45.36±0.56%.The difference was significant between Ⅰand Ⅱ,Ⅲgroup(P<0.05).There was no difference between metal "O" ring and "T" ring(P>0.05);CD_(34)-MVD were 4.67±3.51,18.17±2.43 and 19.65±4.03 in Ⅰ,Ⅱ,and Ⅲ group,and were lower inⅠgroup than Ⅱand Ⅲ group. The metal "O" ring and "T" ring were also no different(P>0.05).Conclusion:This investigation illustrated the expression of VEGF,CD34 in IUD bleeding endometrium glandular epithelium was more weak than the group of normal endometrium,and the difference was significant.This indicated that the low expression of VEGF and CD34 influenced the injured endometrium and vascular recovery ability and induced IUD bleeding.In IUD bleeding endometrium,there was no difference between metal "O" ring and "T" ring with copper.