VEGF、RANTES、sflt-1及MCP-1在子宫内膜异位症合并代谢综合征的表达及意义

Expression and significance of VEGF,RANTES,sflt-1 and MCP-1 in patients with endometriosis associated with metabolic syndrome

目的 探究血管内皮生长因子（VEGF）、T细胞表达和分泌的调节性激活因子（RANTES）、血管内皮生长因子可溶性受体（sflt-1）及单核细胞趋化蛋白-1（MCP-1）在子宫内膜异位症合并代谢综合征的表达及意义。方法 选取2012年1月至2015年4月期间内在江汉大学附属医院妇产科接受治疗的子宫内膜异位症合并代谢综合征240例患者作为研究组,同时选择输卵管系膜囊肿、卵巢良性肿瘤或是宫颈病变患者210例作为对照组。研究组患者根据病变部位、大小以及病灶粘连程度,分为Ⅰ~Ⅳ期,Ⅰ~Ⅱ期患者130例,Ⅲ~Ⅳ期患者110例。采用ELISA对患者血清及腹腔液中sflt-1、VEGF、MCP-1、RANTES表达表达水平进行检测,对比不同组别患者各项指标。结果 研究组患者血清及腹腔液内VEGF、sflt-1、MCP-1和RANTES表达水平均高于对照组,组间数据差异有统计学意义（血清：t值分别为119.385、32.115、13.521、104.776,腹腔液内：t值分别为94.576、42.023、14.762、35.738,均P=0.000〈0.05）;在Ⅰ-Ⅱ期组与Ⅲ-Ⅳ期组指标对比中,前者VEGF、sflt-1和R A NTES指标在血清和腹腔液中表达水平均低于后者,数据有显著统计学差异（血清：t值分别为78.152、6.151、49.337,腹腔液内：t值分别为73.424、8.424、23.385,均P=0.000〈0.05）;但MCP-1数据比较无统计学意义（P〉0.05）。结论 在子宫内膜异位症合并代谢综合征与检测指标包括sflt-1、VEGF、MCP-1、RANTES的表达水平存在密切关系,表明上述因子与疾病发生发展机制存在关联,因此可以在临床上将上述指标作为子宫内膜异位症合并代谢综合征的辅助检测生化指标。

Objective To explore the expression and significance of vascular endothelial growth factor （VEGF）, soluble fms-like tyrosine kinase receptor 1 （ silt-1 ）, regulated upon activation, normal T cell expressed and secreted （ RANTES ） and MCP-1 in patients with endometriosis associated with metabolic syndrome. Methods From January 2012 to April 2015, 240 cases of patients with endometriosis combined with metabolic syndrome who received treatment in Affiliated Hospital of Jianghan University were selected as study group, while 210 cases of patients with tubal cyst, ovarian benign tumor or cervical lesions were selected as control group. According to lesion site, size and adhesion degree, patients in the study group were divided into groups of stage I ,Ⅱ , In and Ⅳ. There were 130 patients at stage I -Ⅱ and 110 patients at stage Ⅲ - Ⅳ. The expression levels of RANTES, MCP-1, VEGF and sflt-1 in the serum and peritoneal fluid of patients were detected by ELISA, and the expressions of them were compared among different groups. Results The expression levels of RANTES, MCP-1, sfh-1 and VEGF in the study group were higher than those in the control group, and the differences were statistically significant （t value was 119. 385, 32. 115, 13. 521 and 104. 776, respectively, tperltonealtluid value was 94. 576, 42.023, 14. 762 and 35. 738, respectively, all P = 0. 000 〈 0.05 ）. The expressions of sflt-1, RANTES and VEGF in serum and peritoneal fluid of patients at stage I - II were significantly lower than those of patients at stage Ⅲ - Ⅳ （ t value was 78. 152, 6. 151, and 49. 337, respectively, tperitoneal fluid value was 73. 424, 8. 424 and 23. 385, respectively, all P = 0.000 〈 0.05 ）, but there was no significant difference in MCP-1 （P 〉 0.05）. Conclusion There is a close relationship between silt-1, MCP-1, VEGF and RANTES levels with endometriosis combined with metabolic syndrome, which indicates that these factors are associated with the pathogenesis of the disease.