子宫内膜易位症患者sICAM-1、sVCAM-1、IL-1与不孕的相关研究

Research on the Correlation Between sICAM - 1, sVCAM - 1 and IL - 1 in Endometriosis Patients and Acyesis

目的 探讨子宫内膜易位症(内异症,EM)患者血清及腹腔液(PF)中可溶性细胞间粘附分子1(sICAM-1),可溶性血管细胞间粘附分子1(sVCM-1)、血管内皮细生长因子(VEGF)、白细胞介素1(IL-1)的水平及与不孕的关系和患者PF上清液对人精子活动力的影响。方法将行诊断性腹腔镜检查和开腹手术的不孕患者根据术后诊断分为内异症组(16例)和对照组(12例),采用ELISA法,检测其血清及PF中sICAM-1、sVCAM-1、VEGF、IL-1水平,并将两组患者PF上清液分别与人精子进行体外培养,观察其对人精子活动力的影响,研究EM发生及致不孕的机制。结果EM组PF上述各参数检测值依次为437.5±126.2、46.5±3.27、96.18±20.37、0.96±0.40,与对照组各相应检测值有显著性差异(P<0.01),较血清中含量也明显升高。精子与PF孵育4h后,EM组精子总活率和前向运动率,平均曲线运动速度(VCL)和平均直线运动速度(VSL)与对照组相应检测值差异显著(P<0.01)。结论 PF内环境的病理改变可显著降低精子活力,腹腔液sICAM-1、sVCAM-1、VEGF、IL-1水平升高及巨噬细胞活性增强,是导致内异症的发生及患者不孕的重要原因。

Objective To explore the levels of soluble intercellular adhesive molecule(sICAM - 1), solute vascular intercellular adhesive molecule( sVCAM - 1), vascular endotheliocyte growth factor( VEGF) and interleukin- 1(IL- 1) in the blood serum and peritoneal fluid(PF)of endometriosis( EM) patients, their relation with acyesis,and the effect of supemate of PF on human sperm activity.Methods The acyesis patients who underwent diagnostic abdominoscope examination and laparotomy were divided into EM group(16 cases)and control group(12 cases) according to post - operative diagnosis. Then the levels of sICAM - 1, sVCAM - 1, VEGF and 1L - 1 in the serum and PF were determined with ELBA. And the supermate of both groups were cultured in vitro separately with human sperm to observe its effect on human sperm activity so as to study the mechanism of EM occurrence and acyesis. Results The levels( ng/ml) of in PF of EM group were respectively 437.5 ± 126.2,46. 5 ± 3.27,96. 18 ± 20.37 and 0.96 ± 0.40, which were significantly different from those of the control group(p < 0.01 )and markedly higher than those in the serum. Four hours after incubation of sperm and PF, the total alive rate and forward - moving rate of EM group were both significantly different from those of the control group. Conclusion Pathologic changes of the interior environment of PF may notably lower sperm activity . Increase in both the levels of sICAM - 1, sVCAM - 1. VEGF and IL - Ⅰ in PF and macrophage activity is a significant cause of EM occurrence and acvesis.