动态检测子宫内膜异位症患者血清TNF-α的临床意义

The Clinical Significance of Dynamic Detection of Serum TNF-α in the Endometriosis Patients

目的研究子宫内膜异位症(EM)患者血清TNF-α的水平动态变化及其在EM疗效和预后评价中的意义。方法EM组患者80例,手术前、术后7d、术后3个月、6个月、12个月、18个月、24个月用ELISA法检测外周血清肿瘤坏死因子-α(TNF-α)的水平,并与40例正常健康妇女(对照组)比较。结果EM组术前血清中TNF-α水平均明显高于对照组(P<0.01),且Ⅲ～Ⅳ期患者高于Ⅰ～Ⅱ期(P<0.05)。术后1周血清中TNF-α水平下降,明显低于术前水平(P<0.01)。EM组随访58例,未复发的52例治疗结束后血清TNF-α水平呈下降趋势,复发的6例治疗结束后血清TNF-α水平呈增高趋势。结论EM患者血清TNF-α水平与EM复发有关,EM患者血清TNF-α水平的动态检测有作为EM疗效评价、复发及预后的重要指标。

Objective To investigate the dynamic changes of serum level of tumor necrosis factor-α（TNF-α） in patients with endometriosis and its significance in the evaluation of treatment efficacy and prognosis for patients with endometriosis.Methods The peripheral serum level of TNF-α were detected in Endometriosis patients（EM group,80 cases,of which Ⅰ-Ⅱ of 32 cases,Ⅲ-Ⅳ of 48 cases） before operation,7 days,after 3 months,6 months,12 months,18 months,24 months in and contrasted with 40 normal healthy women（control group） .Results The serum level o TNF-α in endometrisis group before surgery were significantly higher than the mean value in the control group（P 0.01） .The level of serum TNF-α of endometriosis stages Ⅲ-Ⅳ were significantly higher than that of stageⅠ-Ⅱ（P 0.05） .The serum level of TNF-α in endometriosis group before surgery were significantly higher than that one week after surgery（P 0.05） .Of 58 follow-up patients,52 patients did not have recurrence within follow-up period and 6 patients hadrecurrence within follow-up period.After treatment,the serum level of TNF-α in those patients without relapse tend to descend,but in 6 patients with relapse,the level of TNF-α tend to rise.Conclusion The level of serum TNF-α in the EM patients may play an important role in relapse of endometriosis,and serial determination of serum TNF-α may be an important index for evaluation of efficacy,recurrence and prognosis for patients with endometriosis.