血清NGF、TGF-β1和PTGFR在子宫内膜异位症患者中的水平变化及诊断价值

The level changes of serum NGF,TGF-β1 and PTGFR in patients with endometriosis and their diagnostic value

目的探讨血清神经生长因子(NGF)、转化生长因子β1(TGF-β1)和前列腺素F2α受体(PTGFR)在子宫内膜异位症(EMT)患者中的水平变化及诊断价值。方法选择2019年1月至2020年12月在该院就诊的EMT患者117例作为EMT组,选择同期在该院进行体检的健康女性45例为对照组。比较两组血清NGF、TGF-β1和PTGFR水平,比较不同美国生育学会修正的EMT分期法(r-AFS)分期、不同痛经严重程度EMT患者的血清NGF、TGF-β1和PTGFR水平;分析EMT患者血清NGF、TGF-β1和PTGFR水平之间的相关性;分析血清NGF、TGF-β1和PTGFR水平对EMT的诊断价值。结果 EMT组血清NGF、TGF-β1和PTGFR水平明显高于对照组,差异有统计学意义(P<0.05)。r-AFSⅣ期患者血清NGF、TGF-β1和PTGFR水平明显高于Ⅰ~Ⅱ期和Ⅲ期患者,Ⅲ期患者血清NGF、TGF-β1和PTGFR水平明显高于Ⅰ~Ⅱ期患者,差异有统计学意义(P<0.05)。重度痛经患者血清NGF、TGF-β1和PTGFR水平明显高于中度和轻度痛经患者,中度痛经患者血清NGF、TGF-β1和PTGFR水平明显高于轻度痛经患者,差异有统计学意义(P<0.05)。EMT患者血清NGF水平与TGF-β1、PTGFR水平呈正相关(r=0.636、0.816,P<0.05),血清TGF-β1水平与PTGFR水平呈正相关(r=0.729,P<0.05)。血清NGF、TGF-β1、PTGFR联合检测诊断EMT的灵敏度为83.8%,特异度为99.5%,曲线下面积为0.982,明显高于血清NGF、TGF-β1和PTGFR单独检测。结论血清NGF、TGF-β1和PTGFR水平与EMT的发生、发展及痛经严重程度有关,联合检测对EMT具有较高的诊断效能。

Objective To explore the level changes and diagnostic value of serum nerve growth factor(NGF),transforming growth factor β1(TGF-β1) and prostaglandin F2α receptor(PTGFR) in patients with endometriosis(EMT).Methods A total of 117 EMT patients who were treated in the hospital from January 2019 to December 2020 were selected as the EMT group, and 45 healthy women who underwent physical examinations in the hospital during the same period were selected as the control group.Compared the serum levels of NGF,TGF-β1 and PTGFR between the two groups.Compared the serum NGF,TGF-β1 and PTGFR levels in EMT patients with different American Fertility Society revised EMT staging method(r-AFS) stages and different severity of dysmenorrhea.Analyzed the correlations between serum NGF,TGF-β1 and PTGFR levels in EMT patient.Analyzed the diagnostic value of serum NGF,TGF-β1 and PTGFR levels for EMT.Results The serum levels of NGF,TGF-β1 and PTGFR in the EMT group were significantly higher than those in the control group, and the differences were statistically significant(P<0.05).Serum levels of NGF,TGF-β1 and PTGFR in r-AFS stage Ⅳ patients were significantly higher than those in stageⅠ-Ⅱand stage Ⅲ patients, serum NGF,TGF-β1 and PTGFR levels in stage Ⅲ patients were significantly higher than those in stage Ⅰ-Ⅱ patients, and the differences were statistically significant(P<0.05).The levels of serum NGF,TGF-β1 and PTGFR in patients with severe dysmenorrhea were significantly higher than those in patients with moderate and mild dysmenorrhea, the levels of serum NGF,TGF-β1 and PTGFR in patients with moderate dysmenorrhea were significantly higher than those in patients with mild dysmenorrhea, and the differences were statistically significant(P<0.05).Serum NGF level in EMT patients was positively correlated with TGF-β1 and PTGFR levels(r=0.636,0.816,P<0.05),and serum TGF-β1 level was positively correlated with PTGFR level(r=0.729,P<0.05).The sensitivity of the combined detection of serum NGF,TGF-β1,PTGFR in the diagnosis of EMT was 83.8%,the specificity was 99.5%,and the area under the curve was 0.982,which was significantly higher than those of serum NGF,TGF-β1 and PTGFR alone.Conclusion Serum NGF,TGF-β1 and PTGFR levels are related to the occurrence and development of EMT and the severity of dysmenorrhea.Combined detection has high diagnostic efficiency for EMT.