子宫内膜异位症患者血清syndecan-1及MMP-9水平变化及其临床意义

The changes and clinical significance of serum syndecan-1 and MMP-9 levels in patients with differentstages of endometriosis

目的探究不同分期子宫内膜异位症患者血清syndecan-1及MMP-9水平变化。方法收集2014年7月至2016年8月在浙江台州市第一人民医院住院治疗的子宫内膜异位症（endometriosis，EMS）患者94例，Ⅰ期20例、Ⅱ期27例、Ⅲ期28例、Ⅳ期19例，同时选择在浙江台州市第一人民医院正常查体的健康妇女42例作为对照组。空腹状态下采用ELISA法检测EMS组和对照组血清多配体蛋白多糖-1（syndecan-1）及基质金属蛋白酶（matrix metalloprotein-9，MMP-9）水平。结果EMS组血清可溶性syndecan-1（4040.3±467.2）μg/L和MMP-9（130.9±13.5）μg/L水平显著高于对照组（P〈0.05）；随着EMS分期的增高，血清可溶性syndecan-1（I期：（3 216.7±512.5）μg/L，II期：（3 833.6±448.7）μg/L，III期：（4 342.8±379.8）μg/L，Ⅳ期：（4 755.3±421.6）μg/L）和MMP-9（I期：（112.4±14.7）μg/L，II期：（123.5±13.3）μg/L，III期：（136.6±12.9）μg/L，Ⅳ期：（152.7±15.8）μg/L）水平均显著上升（P〈0.05）；EMS患者增生期和分泌期血清可溶性syndecan-1和MMP-9水平差异无统计学意义（P〉0.05）；血清可溶性syndecan-1水平（r=0.832，P=0.000）和MMP-9水平（r=0.764，P=0.000）均和EMS分期呈正相关；血清可溶性syndecan-1和MMP-9水平之间呈正相关（r=0.684，P=0.000）。 结论血清可溶性syndecan-1和MMP-9在EMS患者呈现高水平状态，其血清水平与月经周期无关，2者可能通过协同作用参与EMS的发病及病情进展。

ObjectiveTo explore the changes and clinical significance of serum syndecan-1 and MMP-9 levels in patients with different stages of endometriosis （EMS） .Method89 patients diagnosed as EMS and meeting criterions were collected from Jul. 2014 to Aug. 2016 in our hospital, including 20 cases of stage Ⅰ, 27 cases of stage Ⅱ, 28 cases of stage Ⅲ, and 19 cases of stage Ⅳ. At the same time, 42 healthy women in our hospital were selected as control group. General information of the two groups was comparable. The serum syndecan-1 and MMP-9 levels of EMS group and the control group were detected by ELISA in fasting state.ResultsThe serum syndecan-1 and MMP-9 levels of EMS group were higher than those of the control group （P〈0.05） . The serum syndecan-1 and MMP-9 levels increased significantly with the increase of EMS stage （P〈0.05） . The serum syndecan-1 and MMP-9 levels of EMS group had no significant difference at proliferative phase and secretory phase （P〉0.05） . The levels of serum syndecan-1 （r=0.832, P=0.000） and MMP-9 （r=0.764, P=0.000） were positively correlated with EMS stage. There was a positive correlation between serum syndecan-1 and MMP-9 （r=0.684, P=0.000） .ConclusionSerum soluble syndecan-1 and MMP-9 show high levels in patients with EMS, and the serum levels are not related to the menstrual cycle. They may be involved in the pathogenesis and progression of EMS through synergistic effects.