子宫内膜异位症患者血清CTRP3、Apelin水平与痛经程度、不孕不育关系

Correlation between the levels of serum complement C1q/tumor necrosis factor associated protein 3 and solitary G protein coupled receptor ligand of patients with endometriosis and their dysmenorrhea degree and infertility

目的:探讨子宫内膜异位症(EMS)患者血清补体C1q/肿瘤坏死因子相关蛋白3(CTRP3)、孤独G蛋白耦联受体配体(Apelin)水平及与痛经程度、不孕不育的关系。方法:回顾性收集2019年5月-2022月5月本院收治的EMS患者305例为EMS组,年龄相近的健康体检女性260例为对照组。入院后均采用酶联免疫吸附法检测血清CTRP3、Apelin水平,并采用Spearman相关分析与患者痛经程度关系,采用受试者工作特征(ROC)曲线评估血清CTRP3、Apelin预测EMS合并不孕不育价值。结果:EMS组血清CTRP3(256.63±72.68 ng/ml)低于对照组(465.63±50.41 ng/ml),血清Apelin(4.52±1.96μg/L)高于对照组(1.98±0.36μg/L),且随着EMS痛经疼痛加重血清CTRP3水平逐渐降低、血清Apelin水平逐渐升高,合并不孕不育患者血清CTRP3低于未合并不孕不育患者、Apelin水平高于未合并不孕不孕患者(均P<0.05)。Spearman相关分析显示,CTRP3患者血清CTRP3与痛经程度呈负相关,血清Apelin与痛经程度呈正相关(均P<0.05)。ROC曲线分析,血清CTRP3、Apelin预测子宫内膜异位症合并不孕不育的曲线下面积分别为0.864、0.755,截断值分别为240.36ng/ml、4.02μg/L,敏感度分别为92.3%、92.3%,特异度分别为66.4%,57.1%,二者联合预测的曲线下面积为0.905,敏感度86.6%、特异度85.5%。结论:EMS患者血清CTRP3水平降低、Apelin水平升高,且二者水平与痛经程度密切相关,并有望成为预测EMS合并不孕不育指标。

Objective:To explore the correlation between the levels of serum complement C1q/tumor necrosis factor associated protein 3(CTRP3)and solitary G protein coupled receptor ligand(Apelin)of patients with endometriosis(EMS)and their dysmenorrhea degree and infertility.Methods:A total of 305patients with endometriosis from May 2019to May 2022were selected in study group retrospectively,and 260healthy women with the similar age during the same period were selected in control group.The serum CTRP3and Apelin levels of the patients were detected by enzyme-linked immunosorbent assay.Spearman correlation was used to investigate the relationship between the serum CTRP3and Apelin levels of the patients with endometriosis and their degree of dysmenorrhea.Receiver operating characteristic(ROC)curve was used to evaluate the predictive value of the serum CTRP3and Apelin levels of the patients with endometriosis for their infertility.Results:The serum CTRP3level(256.6±72.7ng/ml)of the patients in the study group was significantly lower than that(465.6±50.4ng/ml)of the patients in the control group,and the serum Apelin level(4.5±2.0μg/L)of the patients was significantly higher than that(2.0±0.4μg/L)of the patients in the control group.With the aggravating of dysmenorrhea of the patients with EMS,the serum CTRP3level had decreased gradually and the serum Apelin level had increased gradually.The serum CTRP3level of the patients with infertility was significantly lower than that of the patients without infertility,and the Apelin level of the patients with infertility was significantly higher(all P<0.05).Spearman correlation analysis showed that serum CTRP3level of the patients with EMS was negatively correlated with their dysmenorrhea,and the serum Apelin level of the patients with EMS was positively correlated with dysmenorrhea(P<0.05).ROC curve analysis showed that the area under the curve of the serum CTRP3level and the Apelin level of the patients for predicting their EMS and infertility were 0.864and 0.755,the cut-off value of which were 240.4ng/ml and 4.0μg/L,the sensitivity of which were 92.3%and 92.3%,and the specificity of which were was 66.4%and 57.1%.The area under the curve,the sensitivity,and the specificity of the combined levels of serum CTRP3and Apelin of the patients for predicting their EMS and infertility were 0.905,86.6%,and 85.5%,respectively.Conclusion:The serum CTRP3level of the patients with EMS decreases and the Apelin level of the patients with EMS increases,and both the levels of CTRP3and Apelinare of the patients are closely related to their dysmenorrhea degree,and which are expected to be the effective indicators for predicting the infertility and EMS of the patients.