子宫内膜异位症患者血清和腹腔液中肿瘤坏死因子及血管内皮生长因子水平的变化及意义

Expression of Tumor Necrosis Factor and Vascular Endothelial Growth Factors in Both Serum and Peritoneal Fluid of Endometriosis Patients

目的:探讨子宫内膜异位症(内异症)患者血清和腹腔液肿瘤坏死因子α(TNF-α)及血管内皮生长因子(VEGF)水平的变化及其在内异症发病中的作用。方法:采用t检验和Pearson相关分析的方法,测定39例内异症患者(内异症组)和25例非内异不孕症患者(对照组)腹腔液中TNF-α及VEGF的含量,进行相关性分析。结果:内异症患者血清和腹腔液TNF-α水平分别为44.18±13.52pg/ml和57.98±19.70pg/ml,与对照组(分别为34.95±9.81pg/ml和42.50±10.32pg/ml)比较,差异有统计学意义(P<0.05)。内异症患者血清和腹腔液VEGF水平分别为39.89±7.26ng/ml和71.97±14.19ng/ml,与对照组(分别为33.88±10.14ng/ml和43.48±9.12ng/ml)比较,差异有统计学意义(P<0.05)。内异症患者血清中TNF-α与VEGF水平无明显相关性(r=0.115,P>0.05),而腹腔液TNF-α与VEGF水平呈明显正相关(r=0.558,P<0.01);内异症患者Ⅰ～Ⅱ期血清和腹腔液中的TNF-α和VEGF水平均较Ⅲ～Ⅳ期患者明显低,差异有统计学意义(P<0.05)。结论:①内异症患者血清和腹腔液中TNF-α水平及VEGF水平明显升高,并随疾病的严重程度而升高,可能在内异症的发生发展中发挥重要作用;②内异症患者腹腔液TNF-α与VEGF水平呈明显正相关,而血清中TNF-α与VEGF水平呈无明显相关性,为内异症的子宫内膜种植学说提供一定的依据。

Objective： To explore the expression of tumor necrosis factor （TNF） and vascular endothelial growth factors （VEGF） in both serum and peritoneal fluid of endometriosis patients and to evaluate the functions of them in the pathogenesis of endometriosis. Methods：39 women with endometriosis （endometriosis group） and 25 infertility women without endometriosis （control group） were enrolled in this study. The levels of TNF-α and VEGF were detected in this two groups and T test and Pearson correlation analysis was adopted as the statistical analysis methods. Results：The levels of TNF-α were 44.18 ± 13.52 pg/ml and 57.98 ± 19.70 pg/ml respectively in serum and peritoneal fluid in endometriosis group,34,95 ± 9.81 pg/ml and 42.50 ± 10.32 pg/ml in control group. There was statistical significance between them （ P〈 0.05）. The levels of VEGF were 39.89± 7.26 ng/ml and 71.97 ± 14.19 ng/ml respectively in serum end peritoneal fluid in endometriosis group,33.88 ± 10.14 ng/ml and 43.48 ± 9.12 ng/ml in control group. There was statistical significance between them （ P〈0.05）. There was no correlation between the serum levels of TNF-α and VEGF in endometriosis group（ r= 0.115, P〉0.05）. There was significant positive correlation between them in peritoneal fluid（ r = 0.558, P 〈 0.01 ）. The levels of TNF-α and VEGF in both serum and peritoneal fluid of moderate or severe endometriosis （stages Ⅲ-Ⅳ ） patients were significantly higher than those in minute and light endometriosis（stages Ⅰ-Ⅱ ）. There was statistical significance （ P〈 0.05）. Conclusions. The levels of TNF-α and VEGF in serum and peritoneal fluid of endometriosis patients are increased,end which are increased with the endometdosis aggravated. There is significant positive correlation between the levels of TNF-α and VEGF in peritoneal fluid of women with endometriosis, and no correlation between them in serum. Therefore, it provides some basis for the hypothesis of endometriotic implants at ectopic sites.