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目的:研究Th1、Th2各细胞因子在不同临床特征的子宫内膜异位症(EMs)患者差异性表达。方法:收集120例拟诊为“EMs”的患者临床资料。患者均于卵泡期行腹腔镜手术探查,术后经病理证实EMs者87例,非EMs者33例,将EMs组和非EMs组患者分别以主要主诉及临床特征如不孕、痛经/慢性盆腔痛、月经异常、卵巢受累进行再分组,应用ELISA法检测患者腹腔液中IL-2、IL-4、IL-6、IL-10、TNF-α、IFN-γ的表达。结果:以“痛经/盆腔痛”为主要临床特征的EMs组与非EMs组患者腹腔液TNF-α表达有显著差异,显示其与EMs盆腔痛有相关性(P=0.00);以“不孕”为主要临床特征的EMs组与非EMs组患者腹腔液IL-2表达有统计学差异(P=0.03);在检查有盆腔包块或月经异常的患者,术中探查卵巢子宫内膜异位囊肿或明确卵巢受累者的腹腔液IL-10在EMs组与非EMs组表达有统计学差异(P=0.01)。结论:在EMs患者Th1/Th2漂移的免疫异常中,不同的细胞因子在发病和临床特征的形成中发挥作用。
Objective: To investigate the differential expression of Th1 and Th2 cytokines in patients with different clinical features of endometriosis (EMs). Methods: Clinical data of 120 patients who were diagnosed as “EMs” were collected. The patients underwent laparoscopic surgery during follicular phase. 87 cases of EMs and 33 cases of non-EMs were confirmed by pathology. The main complaints and clinical features such as infertility, dysmenorrhea / chronic pelvic Pain, abnormal menstruation and ovarian involvement. The expression of IL-2, IL-4, IL-6, IL-10, TNF-α and IFN-γ in peritoneal fluid of patients was detected by ELISA. Results: There was a significant difference in peritoneal fluid TNF-α expression between EMs group and non-EMs group with Dysmenorrhea / pelvic cavity as the main clinical features, which showed that there was a correlation with pelvic pain in EMs (P = 0.00) The expression of IL-2 in peritoneal fluid in EMs group and non-EMs group with “infertility” as the main clinical features was significantly different (P = 0.03); in patients with pelvic mass or abnormal menstruation, intrauterine exploration of ovary The expression of IL-10 in peritoneal fluid of endometriotic cysts or those with definite ovarian involvement was significantly different between EMs group and non-EMs group (P = 0.01). CONCLUSION: Different cytokines play a role in the pathogenesis and clinical features of immune abnormalities in Th1 / Th2 migrations in EMs.