子宫腺肌病/卵巢异位囊肿炎性压力及其与临床特征相关性研究

目的：系统探讨子宫腺肌病/卵巢异位囊肿患者外周血炎性指标变化及其与临床特征的相关性，为子宫腺肌病/卵巢异位囊肿抗炎治疗提供依据。方法：选取来自同济大学附属杨浦医院收治的子宫腺肌病手术患者58例（子宫腺肌病组）、卵巢异位囊肿手术患者37例（卵巢异位囊肿组），健康女性47例（对照组），于增生期抽取外周血，检测血清炎性细胞因子和肿瘤相关抗原浓度，分析炎性压力与临床特征的相关性。结果：子宫腺肌病组外周血中性粒细胞（Neu）、Neu%、中性粒细胞与淋巴细胞比值（NLR）、白细胞介素6（IL-6）、IL-8、CA199、CA125高于对照组，差异有统计学意义（均P＜0.05）；子宫腺肌病组外周血血红蛋白（HGB）低于对照组，差异有统计学意义（Z=688.50，P=0.00）。卵巢异位囊肿组外周血Neu、Neu%、NLR、IL-6、IL-8、肿瘤坏死因子-α（TNF-α）、CA199和CA125高于对照组，差异有统计学意义（均P＜0.05）。子宫腺肌病中度痛经组外周血白细胞（WBC）、CA125高于轻度痛经组，差异有统计学意义（均P＜0.05）。子宫腺肌病重度痛经组外周血WBC、Neu、Neu%、NLR、IL-8和IL-6高于中度痛经组，差异有统计学意义（均P＜0.05）。子宫腺肌病重度痛经组外周血WBC、Neu、Neu%、NLR、IL-6、IL-8和CA125高于轻度痛经组，差异有统计学意义（均P＜0.05）。子宫腺肌病中、重度痛经组外周血HGB低于轻度痛经组，差异有统计学意义（均P＜0.05）。子宫腺肌病经量过多组外周血WBC、Neu、Neu%、NLR、IL-6、IL-8和CA125高于正常月经组，差异有统计学意义（均P＜0.05）。卵巢异位囊肿重度痛经组外周血IL-6、IL-8高于轻度、中度痛经组，差异有统计学意义（均P＜0.05）。子宫内膜异位症患者肿瘤指标与外周血炎性指标在统计学上无明显相关性。结论：子宫腺肌病/卵巢异位囊肿处于全身炎症压力状态，并与临床特征相关，为子宫内膜异位症抗炎治疗提供了依据。。

The Inflammatory Pressure of Adenomyosis/Ovarian Heterotopic Cyst and Its Correlation with Clinical Characteristics

Objective：To investigate the expression of peripheral blood inflammatory index in adenomyosis/ovarian heterotopic cysts systematicly and their correlation with clinical features, providing evidences for anti-inflammatory treatment of adenomyosis/ovarian heterotopic cysts. Methods：58 patients with uterine adenomyosis, 37 patients with ovarian heterotopic cysts, 47 age-matched women without diagnosed endometriosis (control group) were enrolled in our study. Blood inflammatory cytokines and tumor-associated antigens were analyzed by real-time polymerase chain reaction and immunofluore scence technique respectively. Results：The serum expression of Neu, Neu%, NLR, IL-6, IL-8, CA199 and CA125 in adenomyosis group was significantly higher than that in the control group (P＜0.05). The serum expression of HGB in adenomyosis group was significantly lower than that in the control group (Z=688.50, P=0.00). The serum expression of Neu, Neu%, NLR, IL-6, IL-8, TNF-α, CA199 and CA125 in ovary heterotopic cyst group was significantly higher than that in the control group (P＜0.05). WBC and CA125 were obviously higher in adenomyosis moderate dysmenorrhea group than in the mild dysmenorrhea group (P＜0.05). WBC, Neu, Neu%, NLR, IL-6 and IL-8 were significantly expressed in the severe dysmenorrhea group of adenomyosis compared with moderate dysmenorrhea group (P＜0.05). WBC, Neu, Neu%, NLR, IL-6, IL-8 and CA125 were significantly expressed in the severe dysmenorrhea group of adenomyosis compared with mild dysmenorrhea group (P＜0.05). The serum expression of HGB in the severe and mild dysmenorrhea group of adenomyosis was significantly lower than that in the mild dysmenorrhea group (P＜0.05). WBC, Neu, Neu%, NLR, IL-6, IL-8, CA125 were clearly increased in adenomyosis hypermenorrhea group compared with normal menstruation group (P＜0.05). IL-6 and IL-8 were significantly expressed in the severe dysmenorrhea group of ovary heterotopic cyst compared with mild and moderate ovary heterotopic cyst group (P＜0.05). There was no significant correlation between tumor-associated antigenswere and peripheral blood inflammatory cytokines in adenomyosis/ovarian heterotopic cysts patients. Conclusions：Adenomyosis/ovarian heterotopic cysts was a state of systemic inflammatory stress and these indicators were associated with clinical features closely. The results are beneficial to provid a basis for anti-inflammatory treatment of adenomyosis/ovarian heterotopic cysts.