子宫腺肌病患者血清炎性因子的表达及与盆腔疼痛程度和疾病进展的关系

Expressions of serum inflammatory factors and their relationship with severity of pelvic pain and disease progression in patients with adenomyosis

目的探讨子宫腺肌病(adenomyosis,AM)患者血清胰岛素样生长因子-I(IGF-Ⅰ)、白细胞介素IL-17、IL-22的表达及与盆腔疼痛程度、疾病进展的关系。方法选取焦作市妇幼保健院2020年1月—2022年12月136例AM患者作为研究组,根据盆腔疼痛程度分为轻度疼痛组(n=46)、中度疼痛组(n=62)及重度疼痛组(n=28);根据疾病进展分为Ⅰ级组(n=54)、Ⅱ级组(n=48)及Ⅲ级组(n=34),另取同期80例健康体检者作为对照组。检测并比较研究组及对照组、不同盆腔疼痛程度及疾病进展AM患者血清IGF-Ⅰ、IL-17、IL-22水平,采用ROC曲线分析血清IGF-Ⅰ、IL-17、IL-22水平对AM的诊断价值,采用Spearman系数分析血清IGF-Ⅰ、IL-17、IL-22与AM患者盆腔疼痛程度及疾病进展的相关性。结果研究组血清IGF-Ⅰ、IL-17、IL-22水平均高于对照组(P<0.05);重度疼痛组血清IGF-Ⅰ、IL-17、IL-22水平均高于中度疼痛组及轻度疼痛组,中度疼痛组血清IGF-Ⅰ、IL-17、IL-22水平均高于轻度疼痛组(P<0.05);Ⅲ级组血清IGF-Ⅰ、IL-17、IL-22水平均高于Ⅱ级组及Ⅰ级组,Ⅱ级组血清IGF-Ⅰ、IL-17、IL-22水平均高于Ⅰ级组(P<0.05);ROC曲线显示,血清IGF-Ⅰ、IL-17、IL-22水平联合诊断AM的AUC为0.934,高于三者单独诊断的0.767、0.760、0.766(P<0.05);Spearman相关性分析显示,血清IGF-Ⅰ、IL-17、IL-22水平均与AM患者盆腔疼痛程度及疾病进展呈正相关(P<0.05)。结论IGF-Ⅰ、IL-17、IL-22在AM患者血清中呈高表达,且与盆腔疼痛程度及疾病进展存在相关性,三者有望成为临床诊断AM的参考指标。

Objective To explore the expressions of serum insulin-like growth factor I(IGF-I),interleukin IL-17 and IL-22 and their relationship with the severity of pelvic pain and disease progression in patients with adenomyosis(AM).Methods A total of 136 patients with AM in Jiaozuo Maternal and Child Health Care Hospital were enrolled as study group between January 2020 and December 2022.According to the severity of pelvic pain,they were divided into mild group(n=46),moderate group(n=62)and severe group(n=28).According to disease progression,they were divided into grade I group(n=54),grade II group(n=48)and grade III group(n=34).A total of 80 healthy con⁃trols during the same period were enrolled as control group.The levels of serum IGF-I,IL-17 and IL-22 were com⁃pared between study group and control group,and among AM patients with different severity of pelvic pain and disease progression.The diagnostic value of serum IGF-I,IL-17 and IL-22 for AM was analyzed by ROC curves,and the correlation between serum IGF-I,IL-17,IL-22 and the severity of pelvic pain,disease progression was analyzed by Spearman coefficient.Results The levels of serum IGF-I,IL-17 and IL-22 in study group were higher than those of control group(P<0.05).The levels of serum IGF-I,IL-17 and IL-22 were the highest in severe group,fol⁃lowed by moderate group and mild group(P<0.05).The levels of serum IGF-I,IL-17 and IL-22 were the highest ingrade III group,followed by grade II groupand grade I group(P<0.05).ROC curves showed that AUC of serum IGF-I combined with IL-17 and IL-22 in the diagnosis of AM was 0.934,greater than that of single index(0.767,0.760,0.766,P<0.05).Spearman correlation analysis showed that levels of serum IGF-I,IL-17 and IL-22 were positively correlated with the severity of pelvic pain and disease progression in AM patients(P<0.05).Conclusion The levels of serum IGF-I,IL-17 and IL-22 are high expression in AM patients,which are correlated with the severity of pelvic pain and disease progression.The three are expected to be the reference indexes for clinical diagnosis of AM.