GnRH-a对子宫内膜异位症腹膜纤溶相关因子tPA/PAI-1表达影响的研究

目的:探讨子宫内膜异位症(EM)腹膜组织纤溶相关因子表达水平及使用促性腺激素释放激素类似物(GnRH-a)后表达的变化。方法:应用免疫组织化学方法检测组织型纤溶酶原激活物(tPA)、纤溶酶原激活物抑制剂(PAI)-1、尿激酶纤溶酶原激活物(uPA)在内异症和正常对照组腹膜组织中的表达。分析GnRH-a对各种纤溶相关因子表达的影响。结果:内异症腹膜组织中纤溶相关因子tPA、PAI-1、uPA表达均高于对照组腹膜组织的相应表达,差异有统计学意义(P<0.01)。应用GnRH-a的EM组tPA表达水平明显升高,且PAI-1表达水平降低,差异有统计学意义(P<0.05),GnRH-a应用对uPA表达无明显影响。结论:与正常腹膜相比内异症腹膜组织纤溶相关因子tPA、PAI-1、uPA表达水平发生变化,纤溶活性的变化可能是腹膜对损伤发生的反应。GnRH-a应用使tPA表达升高、PAI-1表达降低,发挥促进纤溶作用,从而抑制腹膜粘连形成。

Study on the expression of tPA and PAI-1 in endometriosis peritoneum treated by GnRH-a

Objective: To investigate the expression levels of fibrinolytic factors in the endometriosis(EM) peritoneum and the different expressions after treated by GnRH-a.Method: Detect the expression levels of tPA,PAI-1 and uPA of peritoneum from EM group and control group by immunohistochemistry methods.Investigate the effect of gonadotropin-releasing hormone analogue(GnRH-a) on the expression of those fibrinolytic factors.Results: The levels of tPA,PAI-1 and uPA from peritoneum of EM group were higher than those in the control group and there was statistically significant differences(P<0.01).GnRH-a could up-regulate tPA levels,down-regulate PAI-1 and the difference was statistically significant(P<0.05),but GnRH-a had no effect on uPA.Conclusions:Compared to the control group,EM group have the up-regulating of tPA,PAI-1,uPA,which may be the response of peritoneum to injuries;GnRH-a may promote fibrinolysis by regulating fibrinolytic factors,such as increasing tPA and decreasing PAI-1,and then inhibit the peritoneal adhesion formation.