宫腔粘连组织中miR-22、TGFβR1表达与三维能量超声参数的相关性及临床意义

Correlation and clinical significance of miR-22 and TGFβR1 expression in intrauterine adhesions and three-dimensional energy ultrasound parameters

目的 研究宫腔粘连(IUA)组织中miR-22、转化生长因子β受体1(TGFβR1)表达与三维能量超声参数的相关性及临床意义。方法 选择2018年1月至2020年12月于安徽理工大学第一附属医院接受IUA分离术的48例IUA患者作为IUA组,54例接受宫腔镜检查的输卵管性不孕患者作为对照组。术前进行三维能量超声检查并检测子宫内膜体积(V)、血管指数(VI)、血流指数(FI)、血管血流指数(VFI);术后收集子宫内膜组织,检测miR-22、TGFβR1的相对表达水平;随访IUA患者术后2年的妊娠情况。结果 IUA组子宫内膜组织中miR-22的相对表达水平及V、VI、FI、VFI均低于对照组,TGFβR1的相对表达水平高于对照组,差异均有统计学意义(P<0.05)。IUA组miR-22与TGFβR1的相对表达水平呈负相关,miR-22的相对表达水平与V、VI、FI、VFI呈正相关,TGFβR1的相对表达水平与V、VI、FI、VFI呈负相关(P<0.05)。IUA组中重度粘连患者子宫内膜组织中miR-22的相对表达水平低于轻度粘连患者,TGFβR1的相对表达水平高于轻度粘连患者,差异有统计学意义(t=3.171、4.640,P<0.05);IUA组中miR-22表达≥中位数患者的2年累积妊娠率高于miR-22表达<中位数患者,TGFβR1表达≥中位数患者的2年累积妊娠率低于TGFβR1表达<中位数患者,差异有统计学意义(χ^(2)=4.580、8.596,P<0.05)。结论 IUA组织中miR-22低表达、TGFβR1高表达与粘连加重、子宫内膜体积缩小及血流灌注减少、妊娠预后不良有关。

Objective To study the correlation between the expression of miR-22,TGF-β receptor 1(TGF-β R1)in intrauterine adhesions(IUA)and the three-dimensional energy ultrasound parameters and its clinical significance. Methods 48 patients with IUA who underwent IUA separation in the First Affiliated Hospital of Anhui University of Technology from January 2018 to December 2020 were selected as the IUA group and 54 patients with tubal infertility who underwent hysteroscopy as the control group. Three-dimensional energy ultrasound was performed before operation,and endometrial volume(V),vascular index(VI),blood flow index(FI)and vascular blood flow index(VFI)were detected. Endometrial tissues were collected after operation and the relative expression level of miR-22 and TGF-β R1 were detected. The pregnancy of IUA patients2 years after operation was followed up. Results The relative expression level of miR-22 and V,VI,FI,VFI in the IUA group were lower than those in the control group,the relative expression level of TGFβR1 was higher than that in the control group(P<0.05). The relative expression level of miR-22 and TGF-β R1 in the IUA group was negatively correlated,and the relative expression level of miR-22 was positively correlated with V,VI,FI and VFI,the relative expression level of TGF-β R1 was negatively correlated with V,VI,FI and VFI.The relative expression level of mi R-22 in endometrium of patients with moderate and severe adhesion in the IUA group was lower than that of patients with mild adhesion,the relative expression level of TGF-β R1 was higher than that of patients with mild adhesion(t=3.171,4.640,P<0.05). In the IUA group,the 2-year cumulative pregnancy rate of patients with mi R-22 expression ≥ median was higher than that of patients with mi R-22 expression.