超声介入硬化治疗后输卵管积液成分的变化

Analysis of hydrosalpinx constituents after interventional ultrasound scleotherapy

目的探讨超声介入硬化治疗后输卵管积液成分及性质的改变。方法2013年4月—2016年4月期间于中国人民解放军第105医院生殖医学中心采用随机数表法随机选取输卵管积液患者16例,分别取超声介入硬化治疗前(A组)和治疗后(B组)输卵管积液样本各16份,检测其pH值、K^+、Na^+、Cl^-、Ca^2+、Mg^2+、总蛋白、葡萄糖浓度,肿瘤坏死因子-α(TNF-α)、白血病抑制因子(LIF)、血管内皮生长因子(VEGF)、胰岛素样生长因子-1(IGF-1)、一氧化氮(NO)、内皮素-1(ET-1)、前列环素(PGI2)、血栓素A2(TXA2)水平及细菌、支原体、衣原体、淋球菌阳性率,进行自身对照比较。结果B组的K^+、Ca^2+、总蛋白、葡萄糖浓度显著高于A组(P<0.05),TNF-α水平[(281.42±55.91)ng/L]显著低于A组[(339.18±59.74)ng/L](P=0.03);pH值(8.23±0.77)、支原体(25.00%)及衣原体阳性率(12.50%)虽低于A组(8.46±0.82,31.25%,18.75%),但差异无统计学意义(P>0.05)。两组细菌、淋球菌培养均未见阳性。结论硬化治疗后输卵管积液部分成分包括K^+、Ca^2+、总蛋白、葡萄糖浓度的升高及TNF-α水平的降低可能有助于降低其细胞毒性作用、改善子宫内膜容受性。

Objective To investigate the constituent changes of hydrosalpinx after interventional ultrasound scleotherapy.Methods Hydrosalpinx samples before and after interventional ultrasound sclerotherapy were collected from randomly selected 16 cases of hydrosalpinx and assigned into group A(before treatment)and group B(after treatment),then the measurement of pH,concentrations of K^+,Na^+,Cl^-,Ca^2+,Mg^2+,protein,glucose,tumor necrosis factor(TNF)-α,leukemia inhibitory factor(LIF),vascular endothelial growth factor(VEGF),insulin-like growth factor(IGF)-1,nitric oxide(NO),endothelin(ET)-1,prostacyclin(PGI2),thromboxane A2(TXA2),and culture of bacteria,mycoplasma,chlamydia and gonococcus were carried out and compared between group A and group B.Results The pH values in hydrosalpinx were comparable before and after the sclerotherapy(8.46±0.82 vs.8.23±0.77).The concentrations of K^+,Ca^2+,protein and glucose in group B were significantly higher than those in group A(P<0.05),while the level of TNF-αin group B[(281.42±55.91)ng/L]was significantly lower than that in group A[(339.18±59.74)ng/L](P=0.03).The positive rates of mycoplasma and Chlamydia in group B(25.00%,12.50%)were lower than those in group A(31.25%,18.75%),but the difference did not reach statistical significance(P>0.05).No bacterial and gonococcus growth were identified in all hydrosalpinx samples.Conclusion Increased concentrations of K^+,Ca^2+,protein,glucose and decreased TNF-αlevel in hydrosalpinx might be a possible mechanism that interventional ultrasound scleotherapy could reduce embryonic toxicity and improve endometrial receptivity of the patients with hydrosalpinx.