摘要
目的探讨子宫肌瘤患者宫腔镜术后血清基质金属蛋白酶-9(MMP-9)、结缔组织生长因子(CTGF)、氧化应激和可溶性CD40配体(s CD40L)与预后的关系。方法选取2018年2月至2019年2月间西安医学高等专科学校附属医院收治的行宫腔镜术的86例子宫肌瘤患者,根据宫腔镜术后疾病是否复发分为复发组32例和未复发组54例。术后随访6个月,比较两组患者术前及术后24h血清MMP-9、CTGF、氧化应激指标[血清活性氧(ROS)、丙二醛(MDA)、晚期氧化蛋白产物(AOPP)、超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)和总抗氧化能力(T-AOC)]和s CD40L水平,采用Logistic多因素回归分析上述指标与患者预后的关系。结果术后,复发组患者血清CTGF水平高于术前(P <0.05),但MMP-9和s CD40L水平差异无统计学意义(P> 0.05)。未复发组患者血清MMP-9和s CD40L水平均低于术前,CTGF高于术前,差异均有统计学意义(均P <0.05)。术后,复发组患者血清MMP-9、CTGF及s CD40L水平均高于未复发组,差异均有统计学意义(均P <0.05)。术后,两组患者ROS、MDA及AOPP水平均高于术前,SOD、GSH-Px及T-AOC均低于术前,差异均有统计学意义(均P <0.05)。术后,复发组患者ROS、MDA及AOPP水平均高于未复发组,SOD、GSH-Px及T-AOC均低于未复发组,差异均有统计学意义(均P <0.05)。血清MMP-9、CTGF、s CD40L、ROS、MDA、AOPP、SOD、GSH-Px和T-AOC是患者术后复发的独立影响因素(均P <0.05)。结论行子宫肌瘤宫腔镜术的患者,术后血清MMP-9、CTGF、s CD40L、ROS、MDA、AOPP、SOD、GSH-Px和T-AOC是患者术后复发的独立影响因素。
Objective To investigate the relationship between serum matrix metalloproteinase-9( MMP-9),connective tissue growth factor( CTGF),oxidative stress,soluble CD40 ligand( s CD40 L) and prognosis in patients with hysteromyoma after hysteroscopy. Methods Eighty-six patients with uterine fibroids who underwent hysteroscopy were selected at between February 2018 and February 2019. Patients were divided into a recurrent group( 32 patients) and non-recurrent group( 54 patients) based on whether the disease recurred after hysteroscopy. A 6-month follow-up was performed to compare the levels of serum MMP-9,CTGF,oxidative stress indicators including reactive oxygen species( ROS),malondialdehyde( MDA) and advanced oxidation protein products( AOPP),superoxide dismutase( SOD),glutathione peroxidase( GSH-Px) and total antioxidant capacity( T-AOC),and s CD40 L between the two groups before and 24 h after the operation. Logistic multivariate regression analysis was used to analyze the relationship between the above indicators and prognosis. Results The serum CTGF level was significantly higher after surgery than that before surgery( P < 0. 05),but there was no significant difference in serum MMP-9 and s CD40 L levels before and after surgery in the recurrent group( P > 0. 05). Serum MMP-9 and s CD40 L levels were significantly lower after surgery than before surgery,while serum CTGF levels were significantly higher after surgery than before surgery in the non-recurrent group( all P < 0. 05). After surgery,the levels of serum MMP-9,CTGF and s CD40 L were significantly higher in the recurrent group than in the non-recurrent group( all P <0. 05). Postoperative ROS,MDA,and AOPP levels were significantly higher in both groups than before surgery,but postoperative SOD,GSH-Px,and T-AOC were significantly lower than before surgery( all P <0. 05). After surgery,the levels of ROS,MDA,and AOPP were significantly higher in the recurrent group than in the non-recurrent group,while SOD,GSH-Px,and T-AOC were significantly lower than in the non-recurrent group( all P < 0. 05). Serum MMP-9,CTGF,s CD40 L,ROS,MDA,AOPP,SOD,GSH-Px,and TAOC are independent factors influencing postoperative recurrence. Conclusion For patients undergoing hysteroscopy for uterine fibroids,postoperative serum MMP-9,CTGF,s CD40 L,ROS,MDA,AOPP,SOD,GSH-Px,and T-AOC are independent influencing factors for postoperative recurrence.
作者
宋艳艳
周洁
王利娟
SONG Yan-yan;ZHOU Jie;WANG Li-juan(Department of Obstetrics and Gynecology,Xi'an Medical College Affiliated Hospital,Xi’an 710000,Shaanxi,China;Department of Oncology,Chang’an Hospital,Xi’an 710016,China)
出处
《中国肿瘤临床与康复》
2020年第8期901-904,共4页
Chinese Journal of Clinical Oncology and Rehabilitation
