血清可溶性黏附分子-1、辅助性T细胞17及系统免疫炎症指数与子宫内膜异位囊肿粘连程度及其术后卵巢储备功能的关系分析

Analysis of the Relationship between Serum Soluble Adhesion Molecule-1,Helper T cell 17 and Systemic Immune Inflammatory Index,Adhesion Degree of Endometriosis Cyst and Postoperative Ovarian Reserve Function

目的:分析血清可溶性黏附分子-1(s ICAM-1)、辅助性T细胞17(Th17)及系统免疫炎症指数(SII)与子宫内膜异位囊肿粘连程度及其术后卵巢储备功能的关系。方法:选择自2020年1月至2023年10月在我院行腹腔镜子宫内膜异位囊肿剥除术的90例子宫内膜异位囊肿患者纳入观察组,根据子宫内膜异位囊肿粘连程度,分为重度粘连组(32例)和非重度粘连组(58例);另选同期的90例健康体检女性纳入对照组。检测所有入选者血清s ICAM-1、抗苗勒管激素(AMH)、卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E2)水平及外周血Th17水平,计算SII,使用多因素Logistic回归分析s ICAM-1、Th17、SII与重度宫内膜异位囊肿粘连的关系,比较重度粘连组与非重度粘连组术后血清AMH、FSH、LH、E2水平,Pearson相关性分析s ICAM-1、Th17、SII与术后卵巢储备功能指标的关系。结果:观察组血清s ICAM-1、外周血Th17水平均高于对照组,SII大于对照组(P<0.05);重度粘连组血清s ICAM-1、外周血Th17水平均高于非重度粘连组,SII大于非重度粘连组(P<0.05);经多因素Logistic回归分析,s ICAM-1、Th17、SII均是重度宫内膜异位囊肿粘连的独立影响因素(P<0.05);重度粘连组术后血清AMH、E2水平均低于非重度粘连组,FSH、LH水平均高于非重度粘连组,差异显著(P<0.05);经Pearson相关性分析,子宫内膜异位囊肿患者s ICAM-1、Th17、SII与术后AMH、E2均呈负相关(P<0.05),与FSH、LH均呈正相关(P<0.05)。结论:血清s ICAM-1、Th17、SII与子宫内膜异位囊肿粘连程度呈正性关联,有助于反映术后卵巢储备功能,值得进一步研究应用。

Objective:To analyse the serum levels of soluble adhesion molecule 1(sICAM 1),17 helper T cells(Th17)and system immune inflammation index(SII)and endometriosis cyst degree of adhesion and the relationship between the ovarian reserve function after surgery for.Methods:From January 2020 to October 2023 in our hospital laparoscopic surgical endometriosis cyst removal of 90 cases of ectopic intrauterine membrane cyst patients into the observation group,according to the degree of endometriosis cyst adhesion,divided into severe adhesion group(32 cases)and the severe adhesion(58 cases).Physical examination work in the same period of 90 cases of healthy women in the control group.To detect all patients serum sICAM 1,resistance to seedling le tube hormone(AMH),follicle-stimulating hormone(FSH),luteinizing hormone(LH),estradiol(E2)levels and peripheral blood levels of Th17,SII.Multiple Logistic regression was used to analyze the relationship between sICAM-1,Th17,SII and adhesion of severe ectopic endometrial cyst.Postoperative serum AMH,FSH,LH and E2 levels were compared between the severe adhesion group and the non-severe adhesion group,SICAM-1,Th17,SII Pearson correlation analysis and the relationship between indicators of ovarian reserve function.Results:The levels of serum sICAM-1 and Th17 in peripheral blood in observation group were higher than those in control group,and SII was higher than those in control group(P<0.05).Serum sICAM-1 and peripheral blood Th17 levels in severe adhesion group were higher than those in non-severe adhesion group,SII was higher than that in non-severe adhesion group(P<0.05).Multiple Logistic regression analysis showed that sICAM-1,Th17 and SII were all independent influencing factors of severe ectopic endometrial cyst adhesion(P<0.05).Postoperative serum AMH and E2 levels were lower than the non-severe group,and FSH and LH levels were higher than the non-severe group(P<0.05).Pearson correlation analysis showed that sICAM-1,Th17 and SII in patients with endometriosis cyst were negatively correlated with postoperative AMH and E2(P<0.05),and positively correlated with FSH and LH(P<0.05).Conclusion:Serum sICAM-1,Th17 and SII are positively correlated with the adhesion degree of endometriosis cyst,which is helpful to reflect the postoperative ovarian reserve function and worthy of further study and application.