子宮內膜異位癥患者子宮內膜VEGF及其與血清CA125、TNF—a水平的關系

[摘要] 目的 探討子宮內膜異位癥患者子宮內膜VEGF及其與血清CA125、TNF-a水平的關系。 方法 方便收集2016年5—9月于福建醫科大學附屬協和醫院接受治療的子宮內膜異位癥患者59例（觀察組）及同期非子宮內膜異位癥婦科疾病患者45例（對照組），檢測觀察組在位子宮內膜、異位子宮內膜及對照組在位子宮內膜的VEGF水平，比較兩組的血清CA125和TNF-a水平，分析觀察組子宮內膜VEGF水平與血清CA125、TNF-a水平的關系。結果 觀察組總體及Ⅰ～Ⅱ、Ⅲ～Ⅳ期的在位內膜中VEGF水平分別為（9.37±1.63）、（10.03±2.06）pg/mL和（7.15±1.82）pg/mL，與對照組的差異無統計學意義（P>0.05）；與對照組在位內膜相比，觀察組總體及Ⅰ～Ⅱ、Ⅲ～Ⅳ期的異位內膜中VEGF水平分別為（29.63±4.25）、（26.54±2.94）pg/mL和（34.15±3.47）pg/mL，血清CA125水平分別為（46.03±3.62）、（52.84±4.15）U/mL和（37.26±3.27）U/mL，血清TNF-a水平分別為（37.48±2.77）、（29.21±2.90）pg/mL和（44.17±3.52）pg/mL，均高于對照組的（8.21±1.49）pg/mL、（13.19±2.64）U/mL和（14.56±1.73）pg/mL，差異均有統計學意義（P<0.05）；觀察組在位內膜不同VEGF水平間血清CA125和TNF-a水平的差異無統計學意義（P>0.05），且在位內膜VEGF水平與血清CA125和TNF-a水平無相關性（P>0.05）；觀察組異位內膜總體及不同分期的VEGF高水平組的血清CA125和TNF-a水平均高于低水平組，差異有統計學意義（P<0.05），且異位內膜VEGF水平與血清CA125和TNF-a水平呈正相關（P<0.05）。 結論 子宮內膜異位癥患者異位子宮內膜VEGF水平升高，且與血清CA125、TNF-a水平呈正相關。

[關鍵詞] 子宮內膜異位癥；子宮內膜；VEGF；CA125；TNF-a

[中圖分類號] R5 [文獻標識碼] A [文章編號] 1674-0742（2016）12（b）-0004-04

Relationship between Endometrium Level of VEGF and Serum Levels of CA125 and TNF-a in Patients with Endometriosis

DENG Ting1， ZHENG Xiang-qin1， CHEN Jian-hui2， ZHENG Zhi-qun3

1.Department of Gynecology， Fujian Provincial Maternity and Child Care Center， Fujian Medical University， Fuzhou，Fujian Province，350001 China；2.Department of Urology， Union Hospital， Fujian Medical University， Fuzhou ，Fujian Province，350001 China；3.Department of Obstetrics and Gynecology， Union Hospital， Fujian Medical University， Fuzhou ，Fujian Province，350001 China

[Abstract] Objective To explore the relationship between endometrium level of VEGF and serum levels of CA125 and TNF-a in patients with endometriosis. Methods Convenient selection 59 patients with endometriosis treated in Union Hospital of Fujian Medical University from May to September 2016 were collected as observation group. Besides， 45 cases of gynecological diseases without endometriosis in the same period were collected as control group. The VEGF levels in the eutopic and ectopic endometrium of observation group and the eutopic endometrium of control group were detected. The serum levels of CA125 and TNF-a were compared between both groups. The relationship between the level of VEGF and serum TNF-a and CA125 were analyzed in the observation group. Results The endometrium levels of VEGF were（9.37±1.63），（10.03±2.06）pg/mL and（7.15±1.82）pg/mL in the total and different stages（Ⅰ～Ⅱ/Ⅲ～Ⅳ） of the observation group， similar with control group（P>0.05）. The ectopic endometrium levels of VEGF were（29.63±4.25），（26.54±2.94）pg/mL and（34.15±3.47）pg/mL，serum levels of TNF-a were（46.03±3.62），（52.84±4.15）U/mL and（37.26±3.27）U/mL， serum levels of CA125 were （37.48±2.77），（29.21±2.90）pg/mL and（44.17±3.52）pg/mL in the total and different stages （Ⅰ～Ⅱ/Ⅲ～Ⅳ） of the observation group， higher than （8.21±1.49）pg/mL，（13.19±2.64）U/mL and（14.56±1.73）pg/mL of the control group （P<0.05）. In the observation group， there was no significant difference in the serum levels of CA125 and TNF-a between patients with different VEGF levels（P>0.05）. No correlation was observed between the level of VEGF in eutopic endometrium and the serum levels of TNF-a and CA125（P>0.05）. Compared with the patients with low level VEGF in observation group， there were higher serum levels of CA125 and TNF-a in patients with high level VEGF（P<0.05）. Serum levels of CA125 and TNF-a were positively correlated with the level of VEGF in ectopic endometrium（P<0.05）. Conclusion The level of VEGF in the ectopic endometrium of patients with endometriosis is increased， and positively correlated with the serum levels of TNF-a and CA125.

[Key words] Endometriosis；Endometrium； VEGF； CA125； TNF-a

子宮內膜異位癥是困擾育齡期婦女身心健康的常見病，疼痛為其主要癥狀，目前病因仍不明確[1]。新生血管是子宮內膜異位癥發生發展的重要基礎，且血管增殖與子宮異位內膜生長關系密切[2]。VEGF是目前臨床研究的與血管生長調控關系最為密切的因子?！?br>