腹腔镜手术对子宫内膜异位症不孕患者血清多项指标的影响

目的：观察腹腔镜手术（ LPS ）对子宫内膜异位症（ EMS ）不孕患者血清基质金属蛋白酶－9（MMP－9）、金属蛋白酶抑制因子－1（TIMP－1）和白细胞介素－2（IL－2）、白细胞介素－10（IL－10）的影响。方法选择2012年8月至2013年8月接受手术的EMS患者80例，根据手术方式的不同分为观察组（接受LPS手术治疗）和对照组（接受开腹手术治疗），每组各40例。观察两组治疗前后血清MMP－9、TIMP－1、MMP－9／TIMP－1和IL－2、IL－10、IL－2／IL－10的变化及术后6个月的受孕情况。结果观察组术后 MMP－9水平（51．21±24．01）μg／L]比治疗前（261．88±190．11）μg／L]明显下降，且观察组比对照组下降更明显；观察组TIMP－1水平（45．88±11．02）μg／L]比对照组（25．32±6．67）μg／L]明显上升（t＝4．846，P＜0．05）；观察组MMP－9／TIMP－1较对照组明显降低，差异有统计学意义（t＝3．636，P＜0．05）；两组治疗后IL－2、IL－10、IL－2／IL－10差异均有统计学意义（t＝4．228、4．415、3．396，均P＜0．05）；观察组受孕率65．0％、流产率7．7％，均优于对照组的30．0％、33．3％（χ^2＝9．825、4．060，均P＜0．05）。结论 LPS是一种治疗EMS的有效方法，可提高血清TIMP－1和IL－2水平，降低MMP9和IL－10水平；改善免疫指标，提高患者的生育能力。

Effect of laparoscopic surgery for a number of indicators in serum of patients with endometriosis and infertil-ity

Objective To observe the effect of laparoscopic operation（ LPS） for the treatment of endometrio-sis（EMS） infertile serum matrix metalloproteinase in patients of matrix metalloproteinases-9（MMP-9）,tissue inhibi-tors of metalloproteinase-1（TIMP-1） and interleukin-2 （IL-2）,interleukin-10（IL-10） .Methods 80 patients with EMS in 2012 August to 2013 August to accept the choice of operation cases,according to the different operation modes for the observation group（received LPS operation therapy） and control group（received open operation treatment）, 40 cases in each group.The changes of serum MMP9, TIMP-1, MMP-9/TIMP-1 and IL-2, IL-10, IL-2/IL-10 and 6 months after operation in the two groups were observed before and after treatment,the pregnancy situation were ob-served.Results The MMP-9 levels of the patients in the observation group（51.21 ±24.01）μg/L] than before treatment（261.88 ±190.11）μg/L] decreased significantly,and the observation group decreased more obviously than that in the control group;the observation group the level of TIMP-1 （45.88 ±11.02）μg/L] than in the control group（25.32 ±6.67）μg/L]increased significantly （t =4.846,P 〈0.05）;observation group MMP-9/TIMP-1 decreased significantly compared with the control group,the difference was statistically significant （ t=3.636,P〈0.05）;the two group after treatment,IL-2,IL-10,IL-2/IL-10,the difference was statistically significant （ t=4.228, 4.415,3.396,all P〈0.05）;the observation group the pregnancy rate was 65%,the abortion rate 7.7%,30.0%and the 33.3%was better than that of the control group （χ^2 =9.825,4.060,all P〈0.05）.Conclusion LPS is an effective method in treating EMS,which can increase the serum TIMP-1 and IL-2 levels,reduce MMP9 and IL-10 level;improve the immune index,improve the patient＆#39;s fertility.