腹腔镜手术及开腹手术对子宫肌瘤术后氧化应激反应及病灶内细胞侵袭的影响

Effect of laparoscopic surgery and laparotomy on oxidative stress response and cell invasion in lesions after hysteromyomectomy

目的:研究腹腔镜手术及开腹手术对子宫肌瘤术后氧化应激反应及病灶内细胞侵袭的影响。方法:选择2014年8月~2017年3月期间在我院接受手术切除治疗的子宫肌瘤患者并进行回顾性分析,根据患者手术方式不同分为腹腔镜组和开腹组。术后即刻及术后24小时,测定血清中氧化应激反应指标的含量;手术切除后,收集子宫肌瘤病灶并测定细胞侵袭指标的表达量。结果:腹腔镜组患者术后即刻及术后24小时血清中MDA、NE、E、Cor、ACTH的含量显著低于开腹组,GSH-Px、T-SOD的含量显著高于开腹组;手术切除后,腹腔镜组患者子宫肌瘤病灶内CXCL12、CXCR4、MMP2、MMP7、MMP9的mRNA表达量显著低于开腹组,TIMP1、TIMP2、RECK、E-cadherin的mRNA表达量显著高于开腹组。结论:腹腔镜手术能够减轻子宫肌瘤切除术后的氧化应激反应并抑制病灶内细胞的侵袭性生长。

Objective:To study the effect of laparoscopic surgery and laparotomy on oxidative stress response and cell invasion in lesions after hysteromyomectomy.Patients with uterine fibroids who received surgical resection in our hospital between August 2014 and March 2017 were retrospectively analyzed and divided into laparoscopy group and laparotomy group according to different surgical procedures.Immediately after surgery and 24 hours after surgery,the contents of oxidative stress response indexes in serum were measured;after surgical resection,the uterine fibroid lesion was collected to determine the expression of cell invasion indexes.Methods:Serum MDA,NE,E,Cor and ACTH levels of laparoscopy group immediately after surgery and 24 hours after surgery were significantly lower than those of laparotomy group while GSH-Px and T-SOD levels were significantly higher than those of laparotomy group;after surgical resection,CXCL12,CXCR4,MMP2,MMP7 and MMP9 mRNA expression in uterine fibroid lesions of laparoscopy group were significantly lower than those of laparotomy group while TIMP1,TIMP2,RECK and E-cadherin mRNA expression were significantly higher than those of laparotomy group.Results:Conclusions:Laparoscopic surgery can reduce the oxidative stress response after hysteromyoma and inhibit the invasive growth of cells in the lesion.