戊酸雌二醇对官腔粘连患者子宫内膜MMP-9表达的影响

摘要

目的 探讨戊酸雌二醇对官腔粘连患者子宫内膜基质金属蛋白酶(MMP-9)表达的影响.方法 选择2012年10月至2014年10月在本院接受治疗的官腔粘连患者126例,按照随机数字表法将患者分为A、B、C三组,每组各42例,三组患者均采用官腔镜官腔粘连分解术治疗,术后根据官腔深度放金属圆环及分别口服戊酸雌二醇3 mg/d、6 mg/d和9 mg/d,对比术前术后月经改变及官腔恢复情况,用免疫组化法检测子宫内膜MMP-9表达情况.结果 C组较A、B组有效提高官腔粘连术的治疗效果,差异有统计学意义(P＜0.05);经治疗后三组患者子宫内膜组织中MMP-9表达均显著提高,其中C组患者提高的幅度大于A组及B组,B组提高的幅度大于A组(P＜0.05).结论 戊酸雌二醇能显著改善官腔粘连患者术后效果,提高患者子宫内膜组织中MMP-9表达并呈剂量依赖性.%Objective To explore the influence of estradiol valerate on expression of matrix metalloproteinase 9 (MMP-9) in endometrium of patients with intrauterine adhesion (IUA).Methods 126 IUA patients treated in our hospital between October 2012 and October 2014 were randomly divided into group A,group B,and group C with 42 cases in each group.All patients of three groups were treated with hysteroscopy intrauterine adhesiolysis.After operation,metal ring was placed according to the depth of uterine cavity,and patients orally took estradiol valerate of 3 mg/d,6 mg/d,and 9 mg/d,respectively.Preoperative and postoperative menstrual changes and uterine recovery condition were compared.Immunohistochemical method was used to detect expression of MMP-9 in endometrium.Results Compared with estradiol valerate of 3 mg/d and 6 mg/d,estradiol valerate of 9 mg/d effectively improved therapeutic effect of intrauterine adhesiolysis,with statistically significant difference (P＜0.05);expression of MMP-9 in endometrial tissue of three groups significantly improved after treatment,while the increased range of group C was larger than those of group A and group B,and the increased range of group B was larger than that of group A (P＜0.05).Conclusion Estradiol valerate could significantly improve the postoperative effect of intrauterine adhesiolysis,enhance the expression of MMP-9 in patients' endometrial tissues in a dose-dependent mode.