【作者】 刘红；

【导师】 戴淑真； 王霞；

【作者基本信息】 青岛大学 ， 妇科学， 2003， 硕士

【摘要】 目的 探讨Th1/Th2细胞因子免疫反应状态与子宫内膜异位症的关系 方法 用双抗体夹心酶联免疫吸附实验(ELISA法)对30例子宫内膜异位症患者及20例非内异症患者血清及腹腔液中Th1型细胞因子IL-2和Th2型细胞因子IL-10的含量进行检测，用免疫组化法检测30例内异症患者异位内膜及10例正常子宫内膜中IL-2及IL-10的表达，结果采用SPSS10.0统计软件包进行，包括非参数Mann-Whitney U检验、卡方检验、Spearman等级相关检验。 结果 (1)内异症患者血清及腹腔液中IL-10水平较对照组明显升高，且随临床期别的增高而增高，差异有显著性(P＜0.05)。(2)内异症Ⅰ-Ⅱ期患者IL-10水平与对照组比较差异无显著性(P＞0.05)。(3)在正常月经周期中，细胞因子水平无明显变化。在内异症患者的增生期与分泌期比较，IL-10水平亦无明显差异(P＞0.05)。但无论在增生期还是分泌期，内异症组IL-10水平均较对照组升高，差异有显著性(P＜0.05)。(4)IL-2水平无论是临床分期还是月经周期分期，与对照组比较均无明显差异(P＞0.05)。(5)IL-2/IL-10比值在内异症患者明显下降，且临床期别越高，下降越明显(P＜0.05)。(6)正常子宫内膜组织中IL-2、IL-10的表达为阴性，内异症异中文摘要位内膜中几.2、IL一10均有表达，份10的表达阳性率(6仔yO)较12(57%)高，差异无显著性。 结论(1) Thl八112细胞因子在体内的平衡状态对于免疫系统发挥正常功能起重要作用，内异症患者几.2/IL一10比值的明显下降，且临床期别越高，下降越明显，说明T七2因子表达增强，Thl因子表达受抑制，机体处于1七2倾向，Thl厂1，h2平衡向ThZ漂移，细胞免疫功能下降，体液免疫功能增强。(2)IL一10在内异症的发生中起重要作用。内异症患者血清、腹腔液中高水平的几.10可在各个环节均造成细胞免疫功能低下，导致自然杀伤(NK)细胞活性的降低，对异位内膜的吞噬作用降低，巨噬细胞的激活引起细胞因子含量增加，刺激异位的内膜生长引起内异症的发生和发展。(3)1一n期内异症患者IL一10水平与对照组比较差异无显著性(P>0.05)，提示轻度内异症患者免疫功能损伤较轻，机体尚有清除异位内膜的能力。(4)在正常月经周期细胞因子水平不随月经周期的改变而变化，可能因为异位内膜本身缺乏典型的周期性变化，或者可能是细胞因子本身就不受性激素的影响。更多还原

【Abstract】 Objective To investigate the relationship between immune reaction state of Thl and Th2 cytokine and endometriosis.Methods Interleukin-2 and interleukin-10 contents in serum and peritoneal fluid of 30 cases with endometriosis were detected by enzyme linked immunoabsorbent assay (ELISA) and compared with the counterparts of 20 cases without endometriosis (controls). Immunohistochemistry was used to evaluate the expression of Interleukin-2 and interleukin-10 in ectopicendometrium of 30 patients with endometriosis and in eutopicendometrium of 10 cases without endometriosis (controls).Results (1) The serum and peritoneal fluid from patients with endometriosis contained significantly greater amounts of IL-10 (PO.05) than those in controls, and there was a significant positive correlation between IL-10 contents and different clinical stages (P<0.05). (2) There was no different amount of IL-10 between patients with mild endometriosis and controls (P>0.05). (3) The level of IL-10 between the proliferative phase and the secretory phase of patients with endometriosis was not significantly different (P>0.05). (4) As a result, the ratio of IL-2/IL-10 decreased in patients with endometriosis (P<0.05). (5) The level of EL-2 was not significantly different between patients with endometriosis and controls (P>0.05). (6) All samples of normal eutopicendometrium were not found to express IL-2 and IL-10 protein, hi ectopicendometrium of 30 patients with endometriosis, the total rate of IL-10 expression was 60%, and IL-2 was 57%, there was no significantly different between themP>0.05).Conclusion (1) The balance of Thl and Th2 played an important role in immune system. The ratio of IL-2/IL-10 decreased in patients with endometriosis, anddecreased more in heavy endometriosis. The high level cytokines of Th2 cells resulted in a shift towards Th2 polarization, which earned inhibition of immune regulation. (2) High level of IL-10 was an important role in the process of endometriosis. It caused macrophage activity enhanced and cytokines increased. At the same time, as natural killer activity decreased, the ectopic endometrium could not be cleared, it grew, planted and spread. (3) The level of IL-10 in mild endometriosis was not higher than controls. It suggested that immune injury was light in mild endometriosis. (4) Cytokine contents had no changes in normal menstrual cycle, perhaps sex hormone had no effect on cytokines.更多还原