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目的研究子宫内膜异位症不孕女性腹腔液的菌群构成,分析TNF-α和IL-37在子宫内膜异位症不孕女性腹腔液的表达,探讨两者在子宫内膜异位症不孕症的发生机制中的临床意义。方法以该院2015年1月-2016年5月收治的子宫内膜异位症且合并不孕或不育的患者43例设为研究组,并以同期已生育且行手术治疗妇科良性病变的非子宫内膜异位症的患者30例为对照组,对两组腹腔液标本进行检测,分析菌群构成,检测并对比TNF-α和IL-37的表达水平,探讨两者在子宫内膜异位症不孕症中的作用。结果两组均发现多种菌群存在,其中以变形菌门和厚壁菌门为主,各菌门在两组间差异无统计学意义(P>0.05)。研究组腹腔液中的TNF-α和IL-37表达均高于对照组,差异有统计学意义(P<0.05),研究组子宫内膜异位症Ⅲ~Ⅳ期TNF-α水平远高于Ⅰ~Ⅱ期,差异有统计学意义(P<0.05);研究组中TNF-α和IL-37存在正相关关系(r=0.621,P<0.001),对照组中两者不存在相关关系(r=-0.217,P=0.627)。结论子宫内膜异位症不孕女性腹腔液中存在多种菌群,但腹腔液菌群存在的微环境在子宫内膜异位症不孕中并无重要作用,而腹腔液中TNF-α和IL-37关系密切,且两者的高表达可能在子宫内膜异位症不孕症的发生机制中起到重要作用。
Objective To study the composition of peritoneal fluid in infertile women with endometriosis and to analyze the expression of TNF-α and IL-37 in peritoneal fluid of infertile women with endometriosis, and to explore the relationship between them in endometriosis Clinical significance of the pathogenesis of infertility. Methods A total of 43 patients with endometriosis and infertility or infertility who were admitted to our hospital from January 2015 to May 2016 were enrolled in the study group and were treated with gynecological benign lesions 30 patients with endometriosis as the control group, the two groups of peritoneal fluid specimens were detected, the composition of the bacteria were analyzed, and compared the expression levels of TNF-α and IL-37 to explore the two in the endometrium Symptoms of sterility in the role. Results A large number of bacteria were found in both groups, of which Proteobacteria and Firmicutes were the main pathogens. There was no significant difference between the two groups (P> 0.05). The levels of TNF-α and IL-37 in the peritoneal fluid of the study group were significantly higher than those in the control group (P <0.05). The levels of TNF-α in stage Ⅲ-Ⅳ of the study group were much higher than those of the control group There was a positive correlation between TNF-α and IL-37 in the study group (r = 0.621, P <0.001), while there was no correlation between the two groups in the control group (P <0.05) r = -0.217, P = 0.627). Conclusion There are many kinds of bacteria in the peritoneal fluid of infertile women with endometriosis, but the microenvironment of the peritoneal fluid flora does not play an important role in infertility of endometriosis. In the peritoneal fluid, TNF-α And IL-37 are closely related, and the high expression of both may play an important role in the pathogenesis of endometriosis infertility.