VEGF蛋白宫腔灌注防治节育器出血的初步临床研究

目的探讨防治节育器（IUD）出血的新方法，研究血管内皮生长因子（VEGF）蛋白对置节育器后出血副反应的疗效及对内膜微血管生成的影响。方法收集60例研究对象，将VEGF蛋白于月经期经导管置人宫腔底部进行灌注，每月1次，共3次。收集置器者的卫生巾及子宫内膜，采用月经图示法评估月经血量，采用月经出血模式统计方法分析出血模式，采用免疫组化法检测内膜VEGF的表达及微血管密度（MVD）。结果VEGF组滴血天数为（11．8±4．9）d，与抗前列腺索组（23．4±11．7）d和对照组（25．2±10．6）d比较，明显缩短，差异有统计学意义（P〈0．05）。出血天数、月经周期长度、月经图示评分差异无统计学意义（P〉0．05）。三组MVD置器后与置器前自身对照均有升高，差异有统计学意义（P〈0．05），VEGF组置器后微血管密度与抗前列腺素组、对照组比较显著升高，差异有统计学意义（P〈0．05）。三组VEGF表达置器后与置器前自身对照均有升高，差异有统计学意义（P〈0．05）。置器后三组间两两比较，差异无统计学意义（P〉0．05）。结论VEGF蛋白宫腔灌注可能缩短置器后滴血时间，与VEGF蛋白促进内膜微血管生成有关。

Preliminary clinical study on VEGF protein intrauterine infusion for prevention of bleeding in women with IUD inserted

Objective To explore the new method for preventive treatment of intrauterine device- induced bleeding, and study the clinical effect of vascular endothelial growth factor （VEGF） protein on IDU - induced bleeding and microvascular anglo- genesis of endometrium. Methods Sixty study subjects were involved. VEGF protein was conducted to the bottom of the uterine cavity through a catheter once a month and 3 times total during menstrual period. Sanitary napkins and endometrium specimens of the subjects were collected. Menstrual blood loss was evaluated by menstrual graphic, and the bleeding model was analyzed. Expression of VEGF and microvascular density （MVD） of endometrium were detected by immunohistochemical meth- od. Results Drop bleeding days in VEGF group were reduced to （ 11.8 _＋ 4.9） days, which were significantly shorter than those of anti - prostaglandin treated group （23.4 ＋ 11.7 days） and control group （25.2 ＋_ 10.6 days）, and the difference was sta- tistically significant （P 〈 0.05）. There was no statistically significant difference in bleeding day, length of menstrual cycle, and menstrual bleeding graphic score between each two groups （P 〉0.05）. After inserting IUD, MVD and expression of VEGF in the three groups were both higher than before using, and the difference was statistically significant （both P〈0.05）. After in- serting IUD, MVD of VEGF group was significantly higher than those of anti - prostaglandin treated group and control group, and the difference was statistically significant （P〈 0.05）. After inserting IUD, no statistically significant difference was found in expression of VEGF between each two groups （ P 〉 0.05 ）. Conclusions Uterine cavity perfusion of VEGF protein may shorten the drop bleeding time after IUD insertion, which possibly relates to VEGF protein promoting endometrial microvascular development.