子宫内膜异位症患者凝血指标、炎性因子和氧化应激指标表达水平的价值

Clinical significance of coagulation indexes,inflammatory factor and oxidative stress index in patients with endometriosis

目的研究子宫内膜异位症患者凝血指标、炎性因子、氧化应激指标表达水平,并探讨其临床价值。方法2016年至2019年3月就诊的120例子宫内膜异位症患者作为异位症组,同期盆腔炎且子宫内膜正常者120例为对照组,观察2组凝血指标[凝血酶原时间(PT)、活化部分凝血酶原时间(APTT)、凝血酶时间(TT)、纤维蛋白原(FIB)和D-二聚体(D-D)、炎性因子[白介素-6(IL-6)、白介素-8(IL-8)、单核细胞趋化蛋白-1(MCP-1)、肿瘤坏死因子-α(TNF-α)、糖类抗原125(CA125)]和氧化应激水平[脂质过氧化特异性产物8-异前列腺素F2α(8-iso-PGF2α)、谷胱甘肽过氧化物酶(GSH-Px)、人活性氧自由基(ROS)、对氧磷酶-1(PON-1)],并观察不同分期子宫内膜异位症患者凝血指标、炎性因子和氧化应激指标的表达水平。结果异位症组ATPP、FIB、D-D、IL-6、IL-8、MCP-1、TNF-α、CA125、8-iso-PGF2α、ROS水平高于对照组,PT、GSH-Px、PON-1水平低于对照组,差异均有统计学意义(P<0.05)。2组TT水平比较,差异无统计学意义(P>0.05)。子宫内膜异位症Ⅲ、Ⅳ期组FIB、IL-6、IL-8、MCP-1、TNF-α、CA125、8-iso-PGF2α、ROS水平高于Ⅰ、Ⅱ期组,GSH-Px、PON-1水平低Ⅰ、Ⅱ期组,差异均有统计学意义(P<0.05)。Ⅲ、Ⅳ期组PT、ATPP、TT水平低于Ⅰ、Ⅱ期组,D-D水平高于Ⅰ、Ⅱ期组,但差异无统计学意义(P>0.05)。结论子宫内膜异位症患者血液呈高凝状态,机体出现炎性表达和氧化应激反应,且随着临床分期增加而相应变化,说明炎性因子和氧化应激可能参与到子宫内膜异位症的发生发展过程中。

Objective To investigate the expression levels of coagulation index,inflammatory factor and oxidative stress in patients with endometriosis,and to explore their clinical significance.Methods A total of 120 patients with endometriosis who were treated in our hospital from March 2016 to March 2019 were enrolled as endometriosis group,at the same time,the other 120 patients with pelvic inflammatory diseases and normal endometrium were enrolled as control group.The coagulation indexes including PT,APTT,TT,FIB,D-D,and nflammatory factors including IL-6,IL-8,MCP-1,TNF-α,and CA125 as well as oxidative stress levels including 8-iso-PGF2α,GSH-Px,ROS,PON-1 were observed and compared between the two groups.Results The levels of ATPP,FIB,DD,IL-6,IL-8,MCP-1,TNF-α,CA125,8-iso-PGF2αand ROS in endometriosis group were significantly higher than those in control group,however,the levels of PT,GSH-Px,PON-1 were significantly lower than those in control group(P<0.05).There were no significant differences in the TT levels between the two groups(P>0.05).The levels of FIB,IL-6,IL-8,MCP-1,TNF-α,CA125,8-iso-PGF2αand ROS in patients with endometriosis at stageⅢandⅣendometriosis were significantly higher than those of patients with endometriosis at stage stageⅠandⅡ,however,the levels of GSH-Px PON-1 in patients with endometriosis at stageⅢandⅣendometriosis were significantly lower than those of patients with endometriosis at stage stageⅠandⅡ(P<0.05).Moreover the levels of PT,ATPP and TT in patients with endometriosis at stageⅢandⅣwere lower than those of patients with endometriosis at stageⅠandⅡ,and the D-D levels were higher than those of patients with endometriosis at stageⅠandⅡ,but,there were no significant differences between the two groups(P>0.05).Conclusion The blood of patients with endometriosis appears hypercoagulable states,and patients show up inflammatory expression and oxidative stress,which change with the clinical stage,which suggests that inflammatory factors and oxidative stress may be involved in the pathogenesis and development of endometriosis.