NLR、CRP及IL-6、IL-17在子宫内膜异位症中的表达及与病情的相关性

目的探讨NLR(中性粒细胞与淋巴细胞比值)、CRP(C反应蛋白)、IL-6(白细胞介素6)、IL-17(白细胞介素17)在子宫内膜异位症(EMs)中的表达水平及其与病情的相关性。方法回顾性分析2017年7月至2019年7月在唐山市妇幼保健院妇科行腹腔镜手术的126例术后病理确诊为EMs的患者作为研究对象,其中Ⅰ~Ⅱ期为轻度组(73例),Ⅲ~Ⅳ期为重度组(53例),选取同期体检的健康妇女50例作为对照组。分别测定各组CRP、IL-6、IL-17及NLR指标的水平,分析各指标的关系并应用Logistic回归分析各指标与EMs严重程度的相关性。结果EMs组患者血清中的CRP、IL-6、IL-17和NLR水平均高于对照组,IL-6分别与IL-17和CRP成正相关(r=0.348,P<0.05;r=0.308,P<0.05),CRP与NLR成正相关(r=0.297,P<0.05)其他指标间无显著相关性。重度组CRP、IL-6、IL-17水平均高于轻度组,差异有统计学意义(P<0.05)NLR重度组与轻度组差异无统计学意义(P>0.05)。Logistic回归分析显示,CRP、IL-6、IL-17与EMs病情均密切相关(P<0.05),三者联合诊断EMs的价值最高。结论CRP、IL-6、IL-17和NLR参与了EMs的发生、发展,三个指标的检测可评估EMs的病情及预后判断,CRP、IL-6、IL-17三个指标联合检测可提高EMs诊断的灵敏度和特异性。

Expressions of CRP,IL-6,IL-17 and NLR in Endometriosis and Their Correlations with Illness

Objective To detect the levels of CRP,IL-6,IL-17and NLR in endometriosis women and explore their relationships with the disease.Methods A retrospective analysis was preformed among 126 patients with pathologically confirmed EMs who underwent laparoscopic surgery in the gynecological department of Tangshan Maternal and Child Health Hospital from July,2017 to July,2019,with stage I-II as the mild group(73 cases),stage III-IV as the severe group(53 cases),and 50 healthy women who underwent physical examination at the same time as the control group.The levels of CRP,IL-6,IL-17 and NLR were measured among all subjects,and the relationships among these indexes were analyzed.Logistic regression was used to analyze the correlation between each index and EMs severity.Results The levels of CRP,IL-6,IL-17 and NLR in serum of patients with EMs were higher than those of the control group.IL-6 was positively correlated with IL-17 and CRP,in which the correlation coefficients were 0.348 and 0.308,respectively(P<0.05).CRP was positively correlated with NLR(r=0.297,P<0.05),but not with other markers.The levels of CRP,IL-6 and IL-17 in the severe group were higher than those in the mild group(P<0.05).Logistic regression analysis showed that CRP,IL-6 and IL-17 were closely related to EMs illness(P<0.05),and the combined detection of these three had the highest diagnostic value.Conclusion Among EMS patients,serum CRP,IL-6,IL-17 and NLR were closely related to the occurrence and development of EMs.CRP,IL-6 and IL-17 are involved in the occurrence and development of EMs,which can be used as indicators to determine the severity of diseases and prognosis.Combination of these three factors in the diagnosis can improve the specificity and sensitivity.