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目的:探讨氧化应激(OS)对子宫内膜异位症(EMs)患者在位内膜容受性的影响。方法:采用黄嘌呤氧化酶法及硫代巴比妥酸比色法分别检测60例EMs患者(EMs组)在位内膜(增殖期24例,分泌期36例)和50例正常内膜(对照组)(增殖期21例,分泌期29例)中超氧化物歧化酶(SOD)和丙二醛(MDA)水平。采用同种方法检测对照组内种植窗期内膜17例(A组),EMs组经治疗后口服维生素C(Vc)抗氧化治疗患者恢复正常月经后第1个月种植窗期内膜12例(B组),EMs组经治疗后患者恢复正常月经后第1个月种植窗期内膜11例(C组)和EMs组内种植窗期内膜23例(D组)中SOD和MDA水平。采用免疫组化法检测A、B、C、D组内膜整合素αvβ3表达情况。分析A、B、C、D组内膜整合素αvβ3表达与SOD、MDA水平相关性。结果:无论增殖期还是分泌期内膜,EMs组的SOD水平均低于对照组(P<0.05),MDA水平均高于对照组(P<0.05)。4组种植窗期内膜中,SOD水平为A组>B组>C组>D组,MDA水平为A组B组>C组>D组;B、C、D组中,内膜整合素αvβ3表达与SOD水平均呈正相关(P<0.05),与MDA水平均呈负相关(P<0.05)。结论:EMs患者在位内膜存在OS,其降低在位内膜容受性;治疗后的EMs患者可明显改善在位内膜OS状态,进而改善在位内膜容受性,抗氧化治疗可以起到辅助作用。
Objective: To investigate the effect of oxidative stress (OS) on eutopic endometrial receptivity in patients with endometriosis (EMs). Methods: XRT and thiobarbituric acid colorimetric methods were used to detect the expression of eutopic endometrium (24 cases in proliferative phase, 36 cases in secretory phase) and 50 cases of normal endometrium in EMs group (EMs group) Control group) (21 cases of proliferative phase and 29 cases of secretory phase), the levels of superoxide dismutase (SOD) and malondialdehyde (MDA) were determined. The same method was used to detect the endometrial tissue in the control group in 17 cases (group A), EMs group after treatment with oral vitamin C (Vc) anti-oxidant treatment returned to normal in the first month after implantation of endometrial membrane in 12 cases (Group B). The levels of SOD and MDA in the EMs group after treatment were restored to normal in 11 cases (C group) in the first month after implantation and 23 cases in the endometrial tissue (D group) in the EMs group . Immunohistochemistry was used to detect the expression of integrin αvβ3 in group A, B, C and D. Analysis of the expression of integrin αvβ3 in group A, B, C, D and the correlation between SOD and MDA levels. Results: The levels of SOD in EMs group were lower than those in control group (P <0.05), and MDA levels were higher than those in control group (P <0.05). The levels of SOD in the four groups at the implantation window were A group> B group> C group> D group, MDA level was A group B group> C group > D group. In group B, C and D, the expression of integrin αvβ3 was positively correlated with SOD level (P <0.05), and negatively correlated with MDA level (P <0.05). CONCLUSIONS: OS is present in the eutopic endometrium of EMs patients, which reduces the eutopic endometrial receptivity. The post-treatment EMs patients can significantly improve the eutopic endometrium OS status and thereby improve the eutopic endometrial receptivity. Play a supporting role.