摘要
目的探讨子宫内膜异位症患者血清及子宫内膜组织中miR-21表达水平与不孕不育的相关性。方法选取2019年1月至2020年11月于中南大学湘雅医学院附属海口医院就诊并行腹腔镜手术治疗的120例子宫内膜异位症患者为研究对象(患者均合并不孕症),根据妊娠结局将其分为妊娠成功组69例与不孕不育组51例。采用实时荧光定量PCR法检测血清及子宫内膜组织miR-21表达水平,同时对患者进行子宫内膜异位症生育指数(endometriosis fertility index, EFI)测评;分析血清及子宫内膜组织miR-21水平对子宫内膜异位症患者妊娠结局的预测价值;分析子宫内膜异位症患者血清及子宫内膜组织miR-21表达水平与EFI评分的相关性;分析影响子宫内膜异位症患者妊娠结局的因素。结果不孕不育组血清及子宫内膜组织miR-21表达水平均高于妊娠成功组,差异有统计学意义(P<0.05)。血清、子宫内膜组织miR-21水平预测子宫内膜异位症患者不孕不育的曲线下面积(area under curve, AUC)分别为0.899、0.942,特异性分别为79.7%、92.8%,敏感度分别为82.4%、86.3%;二者联合预测的AUC为0.977,特异性为91.3%,敏感度为92.2%。子宫内膜异位症患者血清及子宫内膜组织miR-21表达水平与EFI评分均呈负相关(r=-0.483、-0.570,P<0.05)。子宫内膜组织miR-21是影响子宫内膜异位症患者术后不孕不育的独立危险因素(P<0.05)。结论子宫内膜异位症术后不孕不育患者血清及子宫内膜组织miR-21水平升高,可用于预测患者妊娠结局。
Objective To investigate the correlation between the expression level of microRNA-21(miR-21) in the serum and endometrial tissue of patients with endometriosis and infertility.Methods 120 patients with endometriosis who were treated with laparoscopic surgery in Affiliated Haikou Hospital of Xiangya Medical College,Central South University from January 2019 to November 2020 were selected as the research objects(the patients were all complicated with infertility),and they were divided into 69 cases in the successful pregnancy group and 51 cases in the infertility group according to pregnancy outcome.The expression level of miR-21 in serum and endometrial tissue was detected by real-time fluorescent quantitative PCR(qRT-PCR) method, and the patient’s endometriosis fertility index(EFI) was measured at the same time;the predictive value of level of miR-21 in serum and endometrial tissue on the pregnancy outcome of patients with endometriosis was analyzed;the correlation between the expression level of miR-21 in serum and endometrial tissue of patients with endometriosis and the EFI score was analyzed;the factors affecting the pregnancy outcome of patients with endometriosis were analyzed.Results The expression level of miR-21 in serum and endometrial tissue in the infertility group was higher than that in the successful pregnancy group, and the difference was statistically significant(P<0.05).The area under the curve(AUC) of level of miR-21 in serum and endometrial tissue predicting infertility in patients with endometriosis was 0.899 and 0.942,respectively, the specificity was 79.7%,92.8%,respectively, and the sensitivity was 82.4.%,86.3%,respectively;the AUC of combined prediction was 0.977,the specificity was 91.3%,and the sensitivity was 92.2%.The expression level of miR-21 in serum and endometrial tissue of patients with endometriosis was negatively correlated with the EFI score(r=-0.483,-0.570,P<0.05).Endometrial tissue miR-21 was an independent risk factor for postoperative infertility in patients with endometriosis(P<0.05).Conclusion The miR-21 level in serum and endometrial tissue of infertile patients after endometriosis are elevated, which can be used to predict the pregnancy outcome of patients.
作者
许文丽
邢秀月
徐川微
Xu Wenli;Xing Xiuyue;Xu Chuanwei(Department of Obstetrics and Gynecology,Affiliated Haikou Hospital of Xiangya Medical College,Central South University,HaiKou HaiNan 570208;Department of Gynecology,Qionghai People's Hospital,Qionghai Hainan 571400,P.R.China)
出处
《中国计划生育和妇产科》
2022年第2期43-46,51,共5页
Chinese Journal of Family Planning & Gynecotokology
