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目的观察子宫内膜异位症(EM)患者治疗前后上皮来源的中性粒细胞活化肽78(ENA-78)表达水平变化,分析ENA-78水平与疼痛分级和盆腔炎症黏连的相关性。方法选取2014年6月—2015年6月在金华市妇幼保健院妇产科确诊的EM患者160例为病例组,其中I~IV期患者各40例;同期住院的非EM患者40例为对照组。采用酶联免疫吸附试验(ELISA)法检测病例组和对照组在治疗前和经促性腺激素释放激素类似物(GnRh-a)治疗3个月、6个月后血清ENA-78水平;盆腔黏连程度根据Hobson评分法分级,疼痛程度根据疼痛程度分级法(RAFS)分级,分析EM患者治疗前后的ENA-78表达与盆腔炎症黏连及疼痛分级的相关性。结果病例组和对照组不同治疗时间血清ENA-78水平差异有统计学意义(P<0.01);病例组患者血清ENA-78水平高于对照组(P<0.01);血清ENA-78水平随治疗时间增加而下降(P<0.01);疼痛程度与血清ENA-78表达水平呈正相关(rs=0.675,P=0.000);盆腔黏连程度与血清ENA-78表达水平呈正相关(rs=0.601,P=0.000)。结论 ENA-78在EM患者血清中高表达,且表达水平越高,盆腔炎症黏连程度和疼痛程度越高,经GnRh-a治疗后ENA-78表达水平明显下降。
Objective To observe the changes of epithelial-derived neutrophil activating peptide 78 (ENA-78) expression in patients with endometriosis (EM) before and after treatment, and to analyze the correlation between ENA-78 level and pain grade and pelvic inflammatory adhesions. Methods From June 2014 to June 2015, 160 patients with EM diagnosed in obstetrics and gynecology department of Jinhua Maternal and Child Health Hospital were selected as the case group, of which 40 cases were stage I-IV patients. 40 cases of non-EM patients hospitalized in the same period were compared group. The levels of ENA-78 in serum of patients and controls before and after GnRh-a treatment for 3 months and 6 months were measured by enzyme-linked immunosorbent assay (ELISA) The degree of connection was graded according to Hobson’s score, and the degree of pain was graded according to RAFS. The correlation between ENA-78 expression before and after treatment and pelvic inflammatory adhesion and grade of pain was analyzed. Results Serum ENA-78 levels were significantly higher in case group and control group at different treatment time (P <0.01), serum ENA-78 level was higher in case group than in control group (P <0.01) (P <0.01). There was a positive correlation between the degree of pain and the level of serum ENA-78 (rs = 0.675, P = 0.000). The pelvic adhesion was positively correlated with the level of ENA-78 = 0.000). Conclusion ENA-78 is highly expressed in the serum of patients with EM, and the higher the expression of ENA-78, the higher the degree of inflammation and the degree of pain in the pelvic cavity. The expression level of ENA-78 after GnRh-a treatment is significantly lower.