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目的:探讨宫腔粘连(IUA)电切术后应用羊膜对宫腔创伤愈合微环境中的解离素-金属蛋白酶(ADAM)15、17表达的影响,从分子生物学角度评价羊膜预防宫腔再粘连的有效性。方法:选取2010年1月至2012年10月在宁夏医科大学总医院、宁夏医科大学心脑血管病医院经宫腔镜检查确诊为中重度IUA且行宫腔镜下宫腔粘连电切术后应用羊膜球囊者26例。根据粘连程度分为IUA-II(16例)和IUA-III(10例)。Western blot和Real-time PCR法分别检测ADAM15、17的蛋白及mRNA表达水平。比较术中粘连组织及术后1月同部位子宫内膜组织中的ADAM15、17表达水平。结果:1例重度宫腔粘连患者术后失访。羊膜应用1月后,宫腔组织中ADAM15、ADAM17蛋白和mRNA表达均下调(P<0.01)。结论:宫腔粘连电切术后应用羊膜,可降低宫腔创伤微环境中与IUA形成有关的ADAM15和ADAM17的表达,从分子生物学角度评价羊膜应用预防IUA有效。
Objective: To investigate the effect of amniotic membrane on the expression of cleaved-metalloproteinase (ADAM) 15,17 in uterine wound healing microenvironment after IUA resection, and to evaluate the effect of amniotic membrane in the prevention of uterine cavity Re-adhesion effectiveness. Methods: From January 2010 to October 2012 in the Ningxia Medical University General Hospital, Ningxia Medical University Cardiovascular and Cerebrovascular Hospital confirmed by hysteroscopy in severe IUA and hysteroscopic hysteroscopic resection of the uterine cavity after resection Amniotic balloon in 26 cases. According to the degree of adhesion divided into IUA-II (16 cases) and IUA-III (10 cases). The protein and mRNA expression levels of ADAM15 and 17 were detected by Western blot and Real-time PCR respectively. The levels of ADAM15 and 17 in endometrial tissue were compared between the intraoperative adhesions and the same site in January. Results: One case of severe intrauterine adhesions was lost after operation. After 1 month of amniotic membrane application, the expression of ADAM15 and ADAM17 protein and mRNA in uterine tissue were down-regulated (P <0.01). Conclusions: The application of amniotic membrane after intrauterine adhesions resection can reduce the expression of ADAM15 and ADAM17 associated with IUA formation in uterine trauma microenvironment, and evaluate the effectiveness of amniotic membrane application in prevention of IUA from the perspective of molecular biology.