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目的探讨参与子宫内膜异位症发生、发展有关的细胞因子白细胞介素-1β(IL-1β)和C-反应蛋白(CRP)在其内膜组织和血清中的表达变化及在子宫内膜异位症发生过程中的作用。方法选取2005年11月至2006年8月在解放军昆明总医院妇产科就诊的Ⅲ～Ⅳ期卵巢子宫内膜异位症囊肿患者(子宫内膜异位症组)20例及对照组17例(同龄、因其它原因需行子宫内膜诊刮或子宫切除的患者),获取异位和在位子宫内膜组织及患者空腹血,用RT-PCR检测IL-1βmRNA在内膜组织中的表达,用ELISA法检测血清中CRP值。结果子宫内膜异位症组和对照组子宫内膜IL-1βmRNA表达比较差异具有显著性意义(增生期1.21±0.33和分泌期1.43±0.34对0.54±0.12,P<0.05);子宫内膜异位症组分泌期内膜组织IL-1β mRNA表达与增生期相比,差异有显著性意义(1.43±0.34对1.21±0.33,P<0.05);子宫内膜异位症组CRP高于对照组,差异有显著性意义[增生期(5.23±1.72)mg/L和分泌期(6.76±2.23)mg/L对(1.58±0.74)mg/L,P<0.05]。结论IL-1作为前炎性因子可能参与了内膜组织的局部免疫调控,减低腹膜清除异位内膜细胞的能力,促进子宫内膜细胞的黏附和转移;IL-1β和雌二醇有协同上调作用,促使形成异位内膜的趋化因子增加,参与子宫内膜异位症的发生、发展;CRP的检测对子宫内膜异位症患者的辅助诊断可能有意义。
Objective To investigate the expression of interleukin-1β (IL-1β) and C-reactive protein (CRP) involved in the development of endometriosis in endometrium and endometrium, The role of the process of ectopic disease. Methods Twenty patients with stage Ⅲ ~ Ⅳ ovarian endometriosis cyst (endometriosis group) and 17 cases of control group were enrolled in the obstetrics and gynecology department of Kunming General Hospital of PLA from November 2005 to August 2006. (Same age, for other reasons, endometrial curettage or hysterectomy patients), to obtain ectopic and eutopic endometrial tissues and patients with fasting blood, using RT-PCR detection of IL-1βmRNA expression in the intima Serum CRP was detected by ELISA. Results The endometrial IL-1βmRNA expression in endometriosis group and control group were significantly different (proliferative phase 1.21 ± 0.33 and secretory phase 1.43 ± 0.34 vs 0.54 ± 0.12, P <0.05); endometrial The expression of IL-1βmRNA in endometriosis tissue was significantly higher than that in proliferative phase (1.43 ± 0.34 vs 1.21 ± 0.33, P <0.05). The CRP in endometriosis group was higher than that in control group (5.23 ± 1.72 mg / L in proliferative stage and 6.76 ± 2.23 mg / L in secretory stage (1.58 ± 0.74) mg / L, P <0.05]. Conclusion As a proinflammatory factor, IL-1 may be involved in the local immune regulation of endometrial tissue, reduce the ability of peritoneal ectopic endometrial cells, and promote the adhesion and metastasis of endometrial cells; IL-1β and estradiol are synergistic Upregulation, promoting the formation of ectopic endometrial chemokines increased participation in the occurrence and development of endometriosis; CRP detection of endometriosis in patients with adjuvant diagnosis may be meaningful.