子宫内膜异位症患者血清雌二醇、肿瘤坏死因子-α和血管内皮生长因子检测的临床意义

目的 探讨子宫内膜异位症(EMS)患者血清雌二醇(E_2)、肿瘤坏死因子(TNF)-α和血管内皮生长因子(VEGF)的临床意义.方法 选择EMS患者59例(EMS组),检测患者术前24 h、术后7 d及术后6个月随访时的血清E_2、TNF-αVEGF,并与同期健康查体的育龄妇女60例(对照组)进行比较.结果 EMS组术前血清E2、TNF-α和VEGF(216.5±59.7)ng/L、(30.4±17.5)μg/L、(250.7±88.7)ng/L]均明显高于对照组(100.2±33.2)ng/L、(11.2±3.6)μg/L、(103.2±49.2)ng/L]及术后(121.3±44.6)ng/L、(13.4±6.2)μg/L、(153.9±58.7)ng/L](P<0.01);而EMS组术后血清E_2、TNF-α和VEGF与对照组比较差异均无统计学意义(P>0.05). EMS组Ⅲ～Ⅳ期患者血清E_2、TNF-α和VEGF(316.5±77.6)ng/L、(51.1±12.3)μg/L、(305.1±69.7)ng/L]均显著高于对照组和Ⅰ～Ⅱ期患者(170.7±48.2)ng/L、(25.8±10.1)μg/L、(169.2±36.1)ng/L](P<0.05或<0.01);Ⅰ～Ⅱ期EMS患者血清E_2、TNF-α和VEGF高于对照组(P<0.05). EMS患者术后6个月随访时有9例复发,50例未复发.复发患者血清E_2、TNF-α和VEGF(187.8±46.7)ng/L、(23.9±9.5)μg/L、(185.3±57.4)ng/L]显著高于对照组(P<0.01);未复发患者血清E_2、TNF-αVEGF(112.7±30.3)ng/L、(13.2±4.7)μg/L、(116.4±30.3)ng/L]与对照组比较,差异无统计学意义(P>0.05).结论 血清E_2、TNF-α和VEGF可能在EMS的发生、发展中起重要作用.检测EMS患者血清E_2、TNF-α和VEGF对病情和预后判断均有重要的临床意义.

The clinical significance of the serum estradiol-2,tumor necrosis factor-alpha and vascular endothelial growth factor in patients with endometriosis

Objective To detect the level of the serum estradiol-2 (E_2), tumor necrosis factor-alpha (TNF- α) and vascular endothelial growth factor (VEGF) in patients with endometriosis (EMS) and explore their clinical significance. Methods Fifty-nine EMS patients from January 2006 to January 2009 were selected as EMS group and 60 normal women were selected as control group. The serum E_2,TNF-αand VEGF in EMS group 24 h pre-operation, 7 d post-operation and 6 months after operation were detected, and compared with control group. Results The levels of the serum E_2(216.5 ± 59.7) ng/L],TNF- α (30.4 ± 17.5) μg/L]and VEGF (250.7 ± 88.7) ng/L]in EMS group pre-operation were significantly higher than those in control group (100.2 ± 33.2) ng/L, (11.2 ± 3.6) μg/L, (103.2 ± 49.2) ng/L]and post-operation (121.3±44.6) ng/L, (13.4 ± 6.2) μg/L, (153.9 ± 58.7) ng/L](P < 0.01). But there was no significant difference between control group and post-operation of EMS group (P > 0.05). The levels of the serum E_2 (316.5 ± 77.6) ng/L],TNF-α (51.1 ± 12.3) μg/L]and VEGF (305.1±69.7) ng/L]with stage Ⅲ-Ⅳ in EMS group were higher than those in control group or those with stage Ⅰ - Ⅱ (170.7±48.2) ng/L, (25.8 ± 10.1) μ g/L, (169.2 ± 36.1) ng/L](P < 0.05 or < 0.01). The levels of the serum E_2,TNF- α and VEGF with stage Ⅰ - Ⅱ in EMS group were also higher than those in control group (P < 0.05). Nine patients recurred at 6 months after the operation. The levels of the serum E_2(187.8 ± 46.7) ng/L],TNF- α (23.9 ± 9.5) μg/L]and VEGF (185.3 ± 57.4) ng/L]of the recurred EMS patients stepped up significantly higher than those of the non-recurred EMS patients (112.7±30.3) ng/L, (13.2±4.7) μg/L, (116.4±30.3) ng/L](P < 0.01). While there was no significant difference between control group and non-recurred EMS patients (P >0.05). Conclusions The serum E_2,TNF-αand VEGF may play important roles in the development of the EMS. And the detection of the serum E_2,TNF-αand VEGF is useful to judge the patient's condition and the prognosis of the EMS.