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目的观察放置宫型节育器(intrauterine device,IUD)预防宫腔镜宫腔粘连分离术后再次宫腔粘连(intrauterine adhesion,IUA)临床疗效,比较结缔组织生长因子(connective tissue growth factor,CTGF)、血小板源性生长因子(platelet-derived growth factors,PDGF)在治疗前后宫内膜的表达变化,探讨其与IUA的关系,进一步阐明宫型节育器防治IUA的作用机理。方法将40例中重度IUA患者随机分为节育器组、空白组,每组20例,采用逆转录聚合酶链式反应(reverse transcription polymerase chain reaction,RT-PCR)方法,观察治疗前后CTGF、PDGF的表达情况。结果治疗前2组CTGF、PDGF的表达水平比较差别无统计学意义(P>0.05),治疗后节育器组宫内膜CTGF、PDGF表达水平低于空白组(P<0.05)。结论 CTGF、PDGF的异常表达导致子宫纤维增殖活跃,可能参与宫腔粘连的发生发展,术后放置宫型节育器可降低CTGF、PDGF表达,减少粘连形成,有效预防术后再次粘连,提高子宫内膜容受性。
Objective To observe the clinical effect of intrauterine device (IUA) after intrauterine device placement (IUD) in prevention of intrauterine adhesion after hysteroscopic adhesions, and to compare the effect of connective tissue growth factor (CTGF) The expression of platelet-derived growth factors (PDGF) in the endometrium before and after treatment, to explore its relationship with IUA, to further clarify the mechanism of IUD control mechanism. Methods Forty patients with moderate to severe IUA were randomly divided into IUD group and blank group, with 20 cases in each group. RT-PCR was used to observe the changes of CTGF, PDGF The expression of the situation. Results There was no significant difference in the expression of CTGF and PDGF between the two groups before treatment (P> 0.05). The expression of CTGF and PDGF in endometrium of IUD group was lower than that of blank group after treatment (P <0.05). Conclusions The abnormal expression of CTGF and PDGF lead to the active proliferation of uterine fibroids, which may be involved in the development of intrauterine adhesions. After IUD insertion, the IUD can reduce the expression of CTGF and PDGF, reduce the formation of adhesions, prevent the re-adhesions and increase the intrauterine Membrane tolerance.