腹腔镜下卵巢型子宫内膜异位囊肿剥除术后T辅助细胞1/T辅助细胞2的动态漂移

Dynamic drifting of Th1/Th2 cytokines after laparoscopic oophorocystectomy

目的研究腹腔镜下卵巢子宫内膜异位囊肿剥除术后Th1(T辅助细胞1)、Th2(T辅助细胞2)各细胞因子的动态变化。方法 2009年7月～2011年8月收住宁夏医科大学附属医院妇科行腹腔镜下卵巢子宫内膜异位囊肿剥除术并经术后病理证实诊断的患者36人,ELISA法检测手术前2d、术后2h、术后72h血清的IL-2(白介素2)、IL-4(白介素4)、IL-6(白介素6)、IL-10(白介素10)、TNF-α(肿瘤坏死因子α)及IFN-γ(干扰素γ)表达变化。结果 IFN-γ在术后2h下降明显,术后72h复又升高,且升高程度与术后2h以及术前相比均有统计学差异;IL-4、IL-6在术后2h升高明显,术后72h下降,且下降程度与术后2h以及术前相比均有统计学差异;IFN-γ/IL-4比值在术后2h下降,与术前相比有统计学差异,而术后72h比值升高,与术后2h及术前均有统计学差异。结论腹腔镜下卵巢型子宫内膜异位囊肿剥除术有利于纠正Th2漂移,破坏了有利于异位内膜生长的免疫环境。

[Objective] To study the dynamic changes of Th1/Th2 cytokines after laparoscopic oophorocystectomy. [Methods] A prospective analysis was performed on 36 patients who were admitted in Affiliated Hospital of Ningxia Medical University from July 2009 to August 2011.They suffered from laparoscopic Oophorocystectomy, and were confirmed endometriosis by postoperative pathology. ELISA method was used to measure the expression changes of IL-2, IL-4, IL-6, IL-10, TNF-α and IFN-γ in peripheral blood serum at the time of 2 days before laparoscopic operation, 2 hours after laparoscopic operation and 72 hours after operation. [Results] IFN-γ reduced obviously in 2 hours after operation, and increased again in 72 hours, and the increasing degree was statistically significant compared with 2 hours after operation and preoperation. IL-4 and IL-6 increased obviously in 2 hours after operation and decreased again in 72 hours after operation. The decreasing degree was statistically significant compared with 2 hours after operation and preoperation. The proportion of IFN-γand IL-4 decreased in 2 hours after operation, the decreasing degree was statistically significant compared with preoperation. The proportion of IFN-γand IL-4 increased in 72 hours after operation, the increasing degree was statistically significant compared with 2 hours after operation and preoperation. [Conclusion] Laparoscopic oophorocystectomy is a good way for the correction of Th2 drifting and may destroy the immune environment of the endometrium.