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目的:探讨宫腔镜冷刀技术通过调控微小RNA（miR）-29b的表达对宫腔粘连患者的治疗效果和术后炎性反应的影响。方法:回顾性分析浙江省医疗健康集团杭州医院2018年1—12月收治的166例宫腔粘连患者的临床资料，其中行宫腔镜冷刀技术治疗83例（冷刀组），行宫腔镜下电切手术治疗83例（电切组）。比较两组手术时间、住院时间。于术后3个月随访，观察患者月经量改变情况，并行宫腔镜复查，观察宫腔内形态变化情况，评估疗效；检测子宫内膜组织白细胞介素（IL）-6、IL-8、肿瘤坏死因子（TNF）-α、C反应蛋白（CRP）和miR-29b相对表达量。结果:冷刀组手术时间和住院时间明显短于电切组[（20.01 ± 1.93）min比（26.46 ± 2.25）min和（3.84 ± 1.43）d比（5.01 ± 1.18）d]，差异有统计学意义（n t=12.134和4.051，n P<0.05）。冷刀组月经量和宫腔内形态疗效均明显优于电切组，差异有统计学意义（n P<0.05）。冷刀组术后3个月IL-4和miR-29b明显高于电切组[（33.54 ± 5.61）mmol/L比（21.34 ± 3.62）mmol/L和1.59 ± 0.42比1.16 ± 0.31]，IL-8、TNF-ɑ、CRP明显低于电切组[（18.23 ± 3.67）mmol/L比（31.59 ± 7.20）mmol/L、（9.41 ± 1.41）mmol/L比（12.64 ± 2.24）mmol/L和（7.58 ± 1.59）mg/L比（11.06 ± 2.15）mg/L]，差异有统计学意义（n P<0.01）。Pearson相关分析结果显示，IL-4与miR-29b呈正相关（n r=0.438，n P<0.01），IL-8和TNF-ɑ与miR-29b呈负相关（n r=- 0.295和- 0.377，n P<0.01）。n 结论:宫腔镜冷刀技术可缩短宫腔粘连患者手术时间和住院时间，通过促进miR-29b和抑炎因子的表达，抑制炎性反应，明显提高疗效。“,”Objective:To investigate the effect of hysteroscopic cold knife technique on the treatment effect and postoperative inflammatory response in patients with intrauterine adhesion by regulating the expression of microRNA (miR)-29b.Methods:The clinical data of 166 patients with intrauterine adhesion in Zhejiang Medical and Health Group Hangzhou Hospital from January to December 2018 were retrospectively analyzed. Among them, 83 cases were treated by hysteroscopic cold knife technique (cold knife group) and 83 cases were treated by hysteroscopic electrosurgical operation (electrosurgical group). The operation time and hospitalization time were compared between 2 groups. The patients were followed up 3 months after operation, and the change of menstrual volume were observed; at the same time, the patient underwent hysteroscopy, and the changes of intrauterine morphology were observed in order to evaluate the efficacy; the interleukin (IL)-6, IL-8, tumor necrosis factor (TNF)-α, C-reactive protein (CRP) and miR-29b relative expression in endometrial tissue were detected.Results:The operation time and hospitalization time in cold knife group were significantly shorter than those in electrosurgical group: (20.01 ± 1.93) min vs. (26.46 ± 2.25) min and (3.84 ± 1.43) d vs. (5.01 ± 1.18) d, and there were statistical differences (n t= 12.134 and 4.051, n P<0.05). The menstrual volume and intrauterine morphology efficacy in cold knife group were significantly better than those in electrosurgical group, and there were statistical differences (n P<0.05). The IL-4 and miR-29b 3 months after operation in cold knife group were significantly higher than those in electrosurgical group: (33.54 ± 5.61) mmol/L vs. (21.34 ± 3.62) mmol/L and 1.59 ± 0.42 vs. 1.16 ± 0.31, the IL-8, TNF-ɑ and CRP were significantly lower than those in electrosurgical group: (18.23 ± 3.67) mmol/L vs. (31.59 ± 7.20) mmol/L, (9.41 ± 1.41) mmol/L vs. (12.64 ± 2.24) mmol/L and (7.58 ± 1.59) mg/L vs. (11.06 ± 2.15) mg/L, and there were statistical differences (n P<0.01). Pearson correlation analysis result that IL-4 was positively correlated with miR-29b (n r=0.438, n P<0.01), and the IL-8 and TNF-ɑ were negatively correlated with miR-29b (n r=-0.295 and -0.377, n P<0.01).n Conclusions:Hysteroscopy cold knife technique can shorten the operation time and hospitalization time of the patients with intrauterine adhesion, and significantly improve the curative effect by promoting the expression of miR-29b and anti-inflammatory factors.