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目的探讨基质金属蛋白酶-2(MMP-2)与Th1/Th2细胞平衡状态之间的相互关系及其在子宫内膜异位症(EM)中的作用。方法选择2013年3月-2014年3月在唐山市工人医院妇二科住院经腹腔镜手术并经病理检查确诊为EM患者60例,作为EM组。选择同期行手术治疗的单纯子宫肌瘤患者72例,作为对照组,采用Real-time PCR法检测MMP-2、白细胞介素-4(IL-4)、干扰素-γ(IFN-γ)的mRNA表达情况,并计算IL-4/IFN-γ比值。结果 EM组中MMP-2和IL-4的mRNA表达水平均显著高于对照组,差异有统计学意义(t值分别为3.946、15.58,P<0.05),IFN-γ的mRNA表达水平显著低于对照组,差异有统计学意义(t=3.771,P<0.05),内膜异位组织中IL-4/IFN-γ比值高于对照组,差异有统计学意义(t=10.73,P<0.05);EM组中MMP-2和IL-4的mRNA表达水平在临床Ⅲ~Ⅳ期的表达强度高于Ⅰ~Ⅱ期,差异有统计学意义(t值分别为2.821、2.552,P<0.05),IFN-γ在临床Ⅲ~Ⅳ期的表达强度低于Ⅰ~Ⅱ期,差异有统计学意义(t=2.123,P<0.05),IL-4/IFN-γ比值在临床Ⅲ~Ⅳ期高于Ⅰ~Ⅱ期,差异有统计学意义(t=3.046,P<0.05)。Pear_son相关性分析表明,EM组中MMP-2 mRNA的表达量与IL-4 mRNA表达呈正相关(r_s=0.651,P<0.05),与IFN-γmRNA的表达呈负相关(r_s=0.541,P<0.05),与IL-4/IFN-γ比值呈正相关(r_s=0.682,P<0.05)。结论子宫内膜异位组织中MMP-2表达的增加与Th1向Th2型细胞转变的平衡偏移呈正相关,提示细胞外基质重塑与局部组织炎症密切相关,在促进EM的发生、发展中具有重要作用。
Objective To investigate the relationship between MMP-2 and Th1 / Th2 cell balance and its role in endometriosis (EM). Methods From March 2013 to March 2014, 60 patients with EM were diagnosed as pathological examination by laparoscopy in the hospital of gynecology and maternal department of Tangshan Workers Hospital. 72 patients with simple myoma of uterine fibroids undergoing surgical treatment at the same period were selected as the control group. The expression of MMP-2, IL-4, IFN-γ mRNA expression, and calculate the IL-4 / IFN-γ ratio. Results The mRNA expression levels of MMP-2 and IL-4 in EM group were significantly higher than those in control group (t = 3.946,15.58, P <0.05), and the mRNA expression of IFN-γ was significantly lower The difference was statistically significant (t = 3.771, P <0.05). The ratio of IL-4 / IFN-γ in endometriosis was significantly higher than that in control group (t = 10.73, P < 0.05). The mRNA expression of MMP-2 and IL-4 in stage Ⅲ-Ⅳ was higher than that in stageⅠ-Ⅱ in EM group (t = 2.821,2.552, P <0.05, respectively) ), The expression level of IFN-γ in stage Ⅲ ~ Ⅳ was lower than stage Ⅰ ~ Ⅱ, the difference was statistically significant (t = 2.123, P <0.05). The ratio of IL-4 / IFN- Higher than Ⅰ ~ Ⅱ, the difference was statistically significant (t = 3.046, P <0.05). Pear_son correlation analysis showed that the expression of MMP-2 mRNA in EM group was positively correlated with the expression of IL-4 mRNA (r_s = 0.651, P <0.05) and negatively correlated with the expression of IFN-γmRNA (r_s = 0.05), and positively correlated with the ratio of IL-4 / IFN-γ (r_s = 0.682, P <0.05). Conclusion The increase of MMP-2 expression in endometriosis is positively correlated with the balance shift of Th1 to Th2 type cell transformation, suggesting that extracellular matrix remodeling is closely related to the inflammation of local tissues and has the potential to promote the development and progression of EM Important role.