子宫内膜异位症盆腔粘连程度与腹腔液中基质金属蛋白酶水平的关系

Relationship between degree of pelvic adhesion and matrix metalloproteinases levels in peritoneal fluid of patients with endometriosis

目的研究子宫内膜异位症(EMs)盆腔粘连程度与腹腔液中基质金属蛋白酶(MMPs)水平的关系。方法选择2013年7月-2014年12月在广州市妇女儿童医疗中心行腹腔镜手术的EMs患者80例,对其腹腔液进行多种MMPs含量检测,同时分析盆腔粘连程度与月经异常、不孕、痛经和性交痛的关系。结果在80例EMs患者中,盆腔粘连56例,占70.00%(56/80)。其中Ⅰ期占50.00%(14/28),Ⅱ期占65.38%(17/26),Ⅲ期占93.75%(15/16),Ⅳ期100.00%(10/10)。盆腔粘连程度和临床分期呈正性相关(r=0.544,P<0.05)。EMs患者的盆腔粘连程度与痛经、性交痛及不孕均呈正性相关(r=0.247、0.284、0.309,均P<0.05)。MMP-2、MMP-3、MMP-7、MMP-8、MMP-9水平表达,盆腔中度粘连、重度粘连较无粘连及轻度粘连升高,差异均有统计学意义(均P<0.05)。结论 EMs患者盆腔粘连程度和临床特征及基质金属蛋白酶水平关系密切。

Objective To research the relationship between degree of pelvic adhesion and matrix metalloproteinases（ MMPs） levels in peritoneal fluid of patients with endometriosis. Methods Eighty patients with endometriosis treated by laparoscopic surgery in the hospital from July 2013 to December 2014 were selected,MMPs contents in peritoneal fluid were detected,the relationships between degree of pelvic adhesion and dysmenorrhea,infertility,algopareunia were analyzed. Results Among 80 patients with endometriosis,56 patients were diagnosed as pelvic adhesion,accounting for 0. 00%（ 56 /80）,the proportions of stage Ⅰ,stage Ⅱ,stage Ⅲ,and stage Ⅳ pelvic adhesion were 50. 00%（ 14 /28）,65. 38%（ 17 /26）,93. 75%（ 15 /16）,and 100. 00%（ 10 /10）,respectively. The degree of pelvic adhesion was positively correlated with clinical stage,dysmenorrhea,algopareunia,and infertility（ r = 0. 544,0. 247,0. 284,0. 309,P〈0. 05）.The expression levels of MMP-2,MMP-3,MMP-7,MMP-8,and MMP-9 in moderate and severe pelvic adhesion cases were statistically significantly higher than those in no and mild pelvic adhesion cases（ P〈0. 05）. Conclusion The degree of pelvic adhesion in patients with endometriosis is closely related to clinical features and MMPs levels.