子宫内膜异位症患者细胞因子表达及与盆腔粘连的相关性研究

The relation between the expression of cytokines and the degree of pelvic adhesions in endometriosis

目的探讨细胞因子TNF-α、IL-6与IL-8在子宫内膜异位症（内异症）的表达及其与盆腔粘连程度的相关性。方法选取子宫内膜异位症患者50例,采用ELISA法分别测定手术前血清、术中腹腔液及术后3个月血清标本TNF-α、IL-6、IL-8含量,并分析与粘连的相关性。结果 50例内异症患者中,41例（80.2%）患者合并不同程度的盆腔粘连,内异症患者血清、腹腔液中TNF-α、IL-6及IL-8显著高于对照组（P〈0.05）。内异症Ⅲ~Ⅳ期期患者腹腔液中TNF-α、IL-6及IL-8的水平显著高于Ⅰ~Ⅱ期,Ⅰ~Ⅱ期Ⅲ~Ⅳ期期患者TNF-α水平显著高于对照组（P〈0.05）;术后3个月血清TNF-α、IL-6及IL-8较术前明显下降（P〈0.05）。盆腔粘连程度与腹腔液IL-6、IL-8、TNF-α均呈正相关（r=-0.457,r=0336,r=0263,P〈0.05）;术前血清细胞因子除IL-8（r=0.135,P〉0.05）,TNF-α、IL-6与粘连呈正相关（r=0.521,r=-0.470,P〈0.05）。结论细胞因子TNF-α、IL-6及IL-8与内异症临床分期和治疗疗效密切相关,检测TNF-α、IL-6及IL-8患者血清的变化,可作为子宫内膜异位症术前评估、疗效评价、复发的重要指标。

Objective To investigate the expression of cytokines TNF-a,IL-6 and IL-8 in endometriosis and its correlation with the degree of pelvic adhesions.Methods 50 patients with endometriosis were selected.The TNF-a,IL-6,IL-8 in serum before operation and 3 months after operation and in peritoneal fluid got intra-operation were detected by ELISA.The correlation with adhesions analyzed.Results 41 cases（80.2%）had different degree of pelvic adhesions,and TNF-α,IL-6 and IL-8 in serum and peritoneal fluid were significantly higher than those in the control group（P〈0.05）.TNF-alpha,IL-6 and IL-8 in peritoneal fluid in patients with stage Ⅲ~Ⅳ was significantly higher than in those with Ⅰ~Ⅱ stage.The TNF-ain patients with stage Ⅰ-Ⅱ was significantly higher than those in the control group（P〈0.05）;TNF-α,IL-6 and IL-8 in serum 3 months after operation were significantly decreased compared to those before operation（P〈0.05）.Pelvic adhesion degree and IL-6,IL-8,TNF-ain peritoneal fluid were positively correlated（r=0.457,r=0.336,r=0.263,P〈0.05）;preoperative serum cytokines except IL-8（r=0.135,P〉0.05）,TNF-α,IL-6 was positively associated with adhesions（r=0.521,r=0.470,P〈0.05）.Contusion Cytokines TNF-α,IL-6 and IL-8 were closely related to the clinical stage and therapeutic efficacy in the treatment of endometriosis.The change of TNF-α,IL-6 and IL-8 in endometriosis was an important index to preoperative evaluation,therapeutic evaluation and recurrence.