腹腔镜子宫肌瘤手术对患者免疫、基质金属蛋白酶、血管新生及相关激素影响

The influence of laparoscopic myomectomy on the of immunity function, angiogenesis situation, and levels of matrix metalloproteinases and related hormone levels of women with uterine fibroids

目的:探究腹腔镜手术对子宫肌瘤患者免疫、基质金属蛋白酶-2(MMP-2)及基质金属蛋白酶-9(MMP-9)、血管新生及相关激素水平的影响。方法:选择2015年10月—2017年9月本院收治的子宫肌瘤患者96例,依据手术方法不同分为对照组(n=48)及观察组(n=48),对照组实施开腹子宫肌瘤剔除术,观察组实施腹腔镜子宫肌瘤剔除术。对两组治疗前后免疫球蛋白(IgA、IgG、IgM)、基质金属蛋白酶、血管新生及相关激素水平进行检测。结果:治疗后,IgA、IgG、IgM水平观察组与治疗前比较无差异(P>0.05),对照组较治疗前及观察组降低(P<0.05);两组治疗后MMP-2与MMP-9水平降低,且观察组低于对照组(P<0.05);血管内皮生长因子(VEGF)、表皮细胞生长因子(EGF)、血管内皮细胞生长因子受体2(VEGFR2)水平观察组较治疗前无差异(P>0.05),对照组较治疗前及观察组比较增加(P<0.05);皮质素(Cor)、去甲肾上腺素(NE)、促卵泡刺激素(FSH)及雌二醇(E2)水平观察组较治疗前无差异(P>0.05),对照组Cor、NE、FSH水平较治疗前及观察组增加,E2水平较治疗前及观察组降低(P<0.05)。结论:腹腔镜子宫肌瘤剔除术能更有效地弱化机体产生的免疫抑制作用,抑制肿瘤组织中基质金属蛋白酶的表达及其相关血管细胞增殖分化,减轻机体产生的应激损伤,有助于卵巢功能恢复。

Objective: To explore the influence of laparoscopic myomectomy on on the of immunity function, angiogenesis situation, and levels of matrix metalloproteinases 2 and 9 (MMP-2and MMP-9) and related hormone levels of women with uterine fibroids. Methods: 96 women with uterine fibroids were selected as study subjects, and were divided into control group and observation group (48 cases in each group) according to different surgical methods from October 2015 to September 2017. The levels of immunoglobulin (IgA, IgG and IgM), matrix metalloproteinase, angiogenesis situation, and related hormone levels of women were detected before and after operation. Results: After operation, the levels of IgA, IgG and IgM of all women in the two groups had no significantly difference ( P >0.05), and those of women in the control group were significant lower than those of women in the observation group ( P <0.05). The levels of MMP-2 and MMP-9 of all included women had significantly decrease after operation ( P <0.05), and the levels of MMP-2 and MMP-9 of women in the observation group were significant lower than those of women in the control group ( P <0.05). After operation, the levels of VEGF, EGF and VEGFR2 of women in the observation group had no significant difference ( P >0.05), but those of women in the control group had significantly increased ( P < 0.05 ). After operation, the levels of Cor, NE, FSH and E 2 of women in the observation group had no significant difference ( P >0.05), but levels of Cor, NE, FSH of women in the control group had significantly increased, while E 2 level of women in the control group had significantly decreased ( P <0.05). Conclusion: Laparoscopic myomectomy can effectively decrease the immunosuppressive effect, inhibit the expression of MMP and the proliferation and differentiation of related vascular cells in tumor tissues, can alleviate the stress injury, which can contribute to the recovery of ovarian function.