促性腺激素释放激素激动剂治疗对子宫内膜异位症患者腹腔炎症微环境的消退作用。

Regression of the inflammatory microenvironment of the peritoneal cavity in women with endometriosis by GnRHa treatment.

机构信息

Department of Obstetrics and Gynaecology, Inselspital, University of Berne, Berne, Switzerland.

出版信息

Eur J Obstet Gynecol Reprod Biol. 2013 Oct;170(2):550-4. doi: 10.1016/j.ejogrb.2013.08.010. Epub 2013 Aug 12.

DOI:10.1016/j.ejogrb.2013.08.010

PMID:23993133

Abstract

OBJECTIVE

To investigate the effect of gonadotropin-releasing hormone analogues (GnRHa) on the peritoneal fluid microenvironment in women with endometriosis.

STUDY DESIGN

Peritoneal fluid was collected from 85 women with severe endometriosis (rAFS stage III and IV) during laparoscopic surgery during the proliferative phase. Prior to surgery clinical data were collected. The concentrations of specific markers for endometriosis in the peritoneal fluid were determined using an ELISA and a comparison between peritoneal fluid markers in women using GnRHa and no hormonal treatment was performed using a non-parametric Mann-Whitney U test.

RESULTS

The study included peritoneal fluid from 39 patients who had been administered GnRHa (Zoladex(®)) in the three months prior to surgery and 46 from women with no hormonal treatment in this period. Concentrations of IL-8, PAPP-A, glycodelin-A and midkine were significantly reduced in the GnRHa treatment group compared to women receiving no hormonal treatment. RANTES, MCP-1, ENA-78, TNF-α, OPG, IP-10 and defensin showed no significant change between the two groups.

CONCLUSIONS

GnRHa mediate a significant regression in the inflammatory nature of the peritoneal microenvironment in women with endometriosis.

摘要

目的

研究促性腺激素释放激素类似物（GnRHa）对子宫内膜异位症患者腹腔液微环境的影响。

研究设计

在腹腔镜手术的增殖期，从 85 名患有严重子宫内膜异位症（rAFS 分期 III 和 IV 期）的女性中收集腹腔液。手术前收集临床数据。使用 ELISA 测定腹腔液中特定子宫内膜异位症标志物的浓度，并使用非参数 Mann-Whitney U 检验比较使用 GnRHa 和无激素治疗的女性的腹腔液标志物。

结果

该研究包括了 39 名在手术前三个月内接受 GnRHa（Zoladex®）治疗的患者的腹腔液，以及 46 名在此期间未接受激素治疗的患者的腹腔液。与未接受激素治疗的女性相比，GnRHa 治疗组的 IL-8、PAPP-A、糖蛋白 130（glycodelin-A）和中期因子（midkine）浓度明显降低。RANTES、MCP-1、ENA-78、TNF-α、OPG、IP-10 和防御素在两组之间没有明显变化。