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目的研究子宫内膜异位症(EMs)盆腔粘连程度与腹腔液中基质金属蛋白酶(MMPs)水平的关系。方法选择2013年7月-2014年12月在广州市妇女儿童医疗中心行腹腔镜手术的EMs患者80例,对其腹腔液进行多种MMPs含量检测,同时分析盆腔粘连程度与月经异常、不孕、痛经和性交痛的关系。结果在80例EMs患者中,盆腔粘连56例,占70.00%(56/80)。其中Ⅰ期占50.00%(14/28),Ⅱ期占65.38%(17/26),Ⅲ期占93.75%(15/16),Ⅳ期100.00%(10/10)。盆腔粘连程度和临床分期呈正性相关(r=0.544,P<0.05)。EMs患者的盆腔粘连程度与痛经、性交痛及不孕均呈正性相关(r=0.247、0.284、0.309,均P<0.05)。MMP-2、MMP-3、MMP-7、MMP-8、MMP-9水平表达,盆腔中度粘连、重度粘连较无粘连及轻度粘连升高,差异均有统计学意义(均P<0.05)。结论 EMs患者盆腔粘连程度和临床特征及基质金属蛋白酶水平关系密切。
Objective To study the relationship between the pelvic adhesions in endometriosis (EMs) and the levels of matrix metalloproteinases (MMPs) in peritoneal fluid. Methods From July 2013 to December 2014, 80 patients with EMs undergoing laparoscopic surgery in Guangzhou Women and Children’s Medical Center were enrolled in this study. Various peritoneal fluid samples were collected for MMPs detection. At the same time, pelvic adhesion and abnormal menstruation, infertility, , Dysmenorrhea and painful relationship. Results In 80 cases of EMs patients, pelvic adhesions in 56 cases, accounting for 70.00% (56/80). Among them, stage Ⅰ accounted for 50.00% (14/28), stage Ⅱ accounted for 65.38% (17/26), stage Ⅲ accounted for 93.75% (15/16) and stage IV 100.00% (10/10). Pelvic adhesion was positively correlated with clinical stage (r = 0.544, P <0.05). The pelvic adhesions in patients with EMs were positively correlated with dysmenorrhea, painful sexual intercourse and infertility (r = 0.247,0.284,0.309, all P <0.05). The expression of MMP-2, MMP-3, MMP-7, MMP-8 and MMP-9 were significantly higher in patients with moderate pelvic adhesions and severe adhesions than those without adhesions and mild adhesions ). Conclusion The pelvic adhesions in EMs patients are closely related to clinical features and matrix metalloproteinase levels.