【摘要】：目的:研究不同劑量的戊酸雌二醇(estradiol valerate,E2V)對(duì)大鼠宮腔粘連(intrauterine adhesions,IUA)的防治效果。方法:將48只8~10周齡健康雌性SD大鼠隨機(jī)分為8組:空白對(duì)照組、實(shí)驗(yàn)對(duì)照組、3個(gè)雌激素預(yù)防組(低、中、高劑量)、3個(gè)雌激素治療組(低、中、高劑量)。收集各組大鼠子宮組織,HE染色觀察子宮內(nèi)膜腺體,MASSON染色觀察子宮內(nèi)膜纖維化程度,免疫組化法檢測(cè)子宮內(nèi)膜轉(zhuǎn)化生長(zhǎng)因子-β1(transforming growth factor-β1,TGF-β1)、基質(zhì)金屬蛋白酶-9(matrix metalloproteinase-9,MMP-9)、雌激素受體-α(estrogen receptor-α,ER-α)的表達(dá)水平。結(jié)果:與實(shí)驗(yàn)對(duì)照組相比,3個(gè)雌激素預(yù)防組大鼠的子宮內(nèi)膜腺體計(jì)數(shù)增多(P值均為0.000)、纖維化面積降低(P_(低雌A組)=0.013,P_(中雌A組)=0.021,P_(高雌A組)=0.003),差異均有統(tǒng)計(jì)學(xué)意義,3個(gè)雌激素治療組大鼠的子宮內(nèi)膜腺體計(jì)數(shù)(P_(低雌B組)=0.536,P_(中雌B組)=0.536,P_(高雌B組)=1.000)及纖維化面積(P值均為1.000)與實(shí)驗(yàn)對(duì)照組相比均無(wú)顯著性差異;6個(gè)雌激素組的子宮內(nèi)膜TGF-β1表達(dá)水平均降低(P值均為0.000),其中中、高劑量組均低于低劑量組(P值分別為0.003及0.002),而中、高劑量2組相比無(wú)差異(P=0.842);6個(gè)雌激素組子宮內(nèi)膜MMP-9表達(dá)水平均升高(P值均為0.000),中、高劑量組均高于低劑量組(P值均為0.000),而中、高劑量2組相比無(wú)差異(P=0.379);6個(gè)雌激素組子宮內(nèi)膜ER-α表達(dá)水平均有升高(P值均為0.000),中、高劑量組均高于低劑量組(P值均為0.000),而中、高劑量2組相比無(wú)差異(P=0.513)。結(jié)論:在大鼠IUA建模早期應(yīng)用雌激素,可顯示較好療效,但ER-α飽和后,其療效不隨劑量增加而增強(qiáng);在建模完成后應(yīng)用雌激素,治療效果欠佳,考慮是否與單一治療有關(guān),如能增加其他治療方法也許能增強(qiáng)療效。
[Abstract]:Aim: to study the effect of different doses of estradiol valerate (estradiol valerate,E2V) on intrauterine adhesion (intrauterine adhesions,IUA) in rats. Methods: 48 healthy female SD rats aged 8 weeks and 10 weeks were randomly divided into 8 groups: blank control group, experimental control group, three estrogen prevention groups (low, medium and high doses) and three estrogen treatment groups (low, medium and high doses). To observe the degree of endometrial fibrosis by HE staining in uterine tissue of rats in each group, and to observe the degree of endometrial fibrosis by MASson staining of endometrial gland. The expression of TGF- 尾 1 (transforming growth factor- 尾 1 TGF- 尾 1, matrix metalloproteinase-9 (matrix metalloproteinase-9,MMP-9) and estrogen receptor- 偽 (estrogen receptor- 偽 -ER- 偽) in endometrium were detected by immunohistochemical method. Results: compared with the control group, the endometrial gland count increased (P = 0.000) and the fibrosis area decreased (P _ (0.013) P _ (middle female A) in the three estrogen prevention groups (P _ (0.021) P _ (high female A) 0. 003). There were significant differences in the number of endometrial glands (P < 0.05) and the fibrosis area (P _ (0.013) P _ (middle female A) in the three estrogen prevention groups (P < 0.05). There was no significant difference in endometrial glandular count (P _ (low female B) 0.536P _ (middle female B) and fibrotic area (P = 1.000) between the control group and the control group. The expression level of TGF- 尾 1 in membrane was decreased (P = 0.000). The expression of MMP-9 in the high dose group was lower than that in the low dose group (P = 0.003 and 0.002, respectively), but there was no difference between the two groups (P < 0. 842), and the expression of MMP-9 in the endometrium of the six estrogen groups were all increased (P = 0.000), and those in the high dose group were higher than those in the low dose group (P = 0.000), while in the middle and high dose groups were higher than those in the low dose group (P = 0.000). There was no difference between the two groups (P < 0. 379), and the expression of ER- 偽 in the endometrium of the 6 estrogen groups was higher than that in the low dose group (P = 0.000), while the expression of ER- 偽 in the high dose group was higher than that in the low dose group (P = 0.000), but there was no difference between the middle and high dose groups (P < 0. 513). Conclusion: early use of estrogen in rat IUA model can show a good effect, but after ER- 偽 saturation, the therapeutic effect does not increase with the increase of dose, after modeling, the therapeutic effect of estrogen is not good enough to consider whether it is related to single therapy. If other treatments can be added, they may enhance the efficacy.
【作者單位】： 南方醫(yī)科大學(xué)珠江醫(yī)院婦產(chǎn)科;
【基金】：國(guó)家自然科學(xué)基金資助項(xiàng)目(編號(hào):81270658)
【分類(lèi)號(hào)】：R711.74

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