子宫内膜异位症患者红细胞免疫功能的研究

Investigation of Erythrocyte Immune Function of Patients with Endometriosis

目的了解子宫内膜异位症（内异症）患者的红细胞免疫功能状况。方法按修正的美国生育协会（ＲＡＦＳ）分类法将３８例内异症患者分为３组：Ⅰ、Ⅱ期１３例（Ⅰ、Ⅱ期组），Ⅲ期１５例（Ⅲ期组），Ⅳ期１０例（Ⅳ期组），其中合并有不孕的１３例；另设对照组（２１例）。应用玫瑰花环试验和聚乙二醇沉淀法，检测各组血液中红细胞补体Ｃ３ｂ受体花环（Ｃ３ｂＲＲ）、免疫复合物花环（ＩＣＲ）、红细胞补体Ｃ３ｂ受体花环促进率（ＲＦＥＲ）、花环抑制率（ＲＦＩＲ）４项红细胞免疫功能指标和循环免疫复合物（ＣＩＣ）。结果与对照组比较，内异症各组Ｃ３ｂＲＲ、ＩＣＲ及ＲＦＥＲ均降低（Ｐ＜０．０５或Ｐ＜０．０１），而ＲＦＩＲ与ＣＩＣ均升高（Ｐ＜０．０５）。另外，这５项指标在内异症各组间均无差异（Ｐ＞０．０５）；在内异症未合并不孕与合并不孕者间，亦无差异（Ｐ＞０．０５）。结论内异症患者血清红细胞免疫粘附促进因子减少，红细胞免疫粘附抑制因子增加，由此引起红细胞免疫粘附功能降低，这与内异症的发病可能有关。

Objective To study erythrocyte immune function of patients with endometriosis and explore the pathogenesis of endometriosis. Methods 38 patients with endometriosis diagnosed by laparoscopy or laparotomy and 21 normal women as the control were studied. The patients were divided into three groups by revised American Fertility Society (RAFS) classfication: group one (stageⅠ,Ⅱ; n =13), group two(stage Ⅲ , n =15), and group three(stage Ⅳ, n =10). Using rosette formation test and polyethyleneglycol sedimentation methods, the erythrocyte immune function including C 3b receptor rosette rate (C 3bRR), immune complex rosette rate(ICR), erythrocyte rosette forming enhancing rate (RFER) and inhibitory rate (RFIR), and circulatory immune complex (CIC) was determined. Results The C 3bRR, ICR, and RFER of group one, two, and three were decreased ( P<0.05 or P <0.01), and RFIR and CIC of group one, two, and three were increased ( P <0.05) when compared with those of the control. All parameters had no significant difference among group one, two and three. In addition, these parameters had no significant difference in infertile groups of endometriosis as compared with those of fertile group. Conclusion The erythrocyte immune function of patients with endometriosis is depressed, resulting from decreased erythrocyte immune adherence enhancer and increased inhibitor. These changes of erythrocyte immune function may be related to the pathogenesis of endometriosis.