摘要
目的探讨慢性子宫内膜炎(CE)患者血清单核细胞趋化蛋白-1(MCP-1)水平及其与子宫内膜息肉(EP)、炎症反应的相关性。方法选择2021年6月至2024年6月间我院妇科收治的157例CE患者为研究对象,观察不同临床特征的CE患者MCP-1水平差异,分层回归分析临床特征与MCP-1水平的关系。根据宫腔镜病理结果分为EP组和非EP组,比较2组患者的一般资料、血清性激素和炎症指标,通过多元线性回归分析MCP-1水平与血清性激素和炎症指标的关系,采用logistic回归分析影响因素,应用非条件logistic回归和限制性立方样条模型(RCS)分析MCP-1水平与CE合并EP的关联及剂量-反应关系,并用广义多因子降维模型(GMDR)分析MCP-1与炎症指标在CE合并EP中的交互作用。结果CE患者中,流产次数、白带异常、异常子宫出血、骨盆疼痛和异位妊娠与MCP-1水平显著相关(P<0.05)。EP组患者的卵泡刺激素(FSH)、雌二醇(E_(2))、黄体生成素(LH)和白细胞介素(IL)-6、肿瘤坏死因子α(TNF-α)、IL-1β、C反应蛋白(CRP)水平显著高于非EP组(P<0.05)。MCP-1、E_(2)、TNF-α、IL-1β、IL-6是CE合并EP的独立危险因素(P<0.05)。MCP-1与EP风险呈非线性关系,当MCP-1>30.30 ng/mL时风险显著增加(非线性检验P<0.001)。最佳交互模型为MCP-1、TNF-α、IL-1β和IL-6高表达的协同作用(P<0.05)。结论在CE患者中,MCP-1水平与EP的发生密切相关,并受到性激素E_(2)及炎症指标的正向调控。此外,MCP-1与炎症指标在CE合并EP中存在显著的交互作用,MCP-1可能在CE合并EP的发生和发展中发挥关键作用。
Objective To investigate the correlation between monocyte chemoattractant protein-1(MCP-1)levels and endometrial polyps(EP)as well as inflammatory responses in patients with chronic endometritis(CE).Methods A total of 157 patients with CE admitted to the Department of Gynecology of our hospital between June 2021 and June 2024 were selected as study participants.The differences in MCP-1 level among patients with CE with different clinical characteristics were observed,and stratified regression analysis was used to examine the relationship between different clinical characteristics and MCP-1 level.Based on hysteroscopic pathological results,the patients were divided into the EP group and the non-EP group.The general data,serum sex hormones,and inflammatory markers of the two groups were compared.Multiple linear regression analysis was used to analyze the relationship between MCP-1 levels and serum sex hormones and inflammatory markers.Logistic regression analysis was used for influencing factor analysis.Unconditional logistic regression and restricted cubic spline models were used to analyze the association and dose-response relationship between MCP-1 levels in patients with CE and EP.A generalized multifactor dimensionality reduction(GMDR)model was used to analyze the interaction between MCP-1 and inflammatory markers in patients with CE and EP.Results In patients with CE,the number of abortions,abnormal leukorrhea,abnormal uterine bleeding,pelvic pain,and ectopic pregnancy were significantly correlated with MCP-1 levels(P<0.05).The levels of follicle stimulating hormone(FSH),estradiol(E_(2)),luteinizing hormone(LH),interleukin-6(IL-6),tumor necrosis factorα(TNF-α),interleukin-1β(IL-1β),and C-reactive protein(CRP)in the EP group were significantly higher than those in the non-EP group.MCP-1,estradiol(E_(2)),TNF-α,IL-1β,and IL-6 were independent risk factors for CE complicated by EP(P<0.05).There was a nonlinear relationship between MCP-1 and EP risk,which increased significantly when MCP-1 was>30.30 ng/mL(nonlinear test,P<0.001).The best interaction model was the synergistic effect of MCP-1,TNF-α,IL-1β,and IL-6 overexpression(P<0.05).Conclusion In patients with CE,MCP-1 levels are closely associated with EP occurrence and are positively regulated by the sex hormone E_(2) and inflammatory indicators.Additionally,significant interactions between MCP-1 and inflammatory indicators exist in CE combined with EP,suggesting that MCP-1 may play a key role in the occurrence and development of CE combined with EP.
作者
卢利霞
杨丹丹
LU Lixia;YANG Dandan(Department of Gynecology,Hebei Hospital of Traditional Chinese Medicine,Shijiazhuang 050000,China)
出处
《中国医科大学学报》
北大核心
2026年第3期251-258,共8页
Journal of China Medical University
基金
河北省中医药管理局课题(2023027)。
