子宫内膜息肉术后放置左炔诺孕酮宫内释放系统对IGF―1影响研究.docVIP

子宫内膜息肉术后放置左炔诺孕酮宫内释放系统对IGF―1影响研究 　　[摘要] 目的 研究左炔诺孕酮宫内释放系统对子宫内膜息肉患者子宫内膜组织胰岛素样生长因子-1（IGF-1）表达的影响。 方法 选取2010年1月～2011年12月期间行宫腔镜下子宫内膜息肉切除术182例患者为研究对象，将其随机分为对照组（常规治疗组）94例和研究组（宫内放置左炔诺孕酮宫内释放系统）88例。后通过免疫组化法将术中内膜组织及术后6个月子宫内膜活检IGF-1的表达情况进行对比，且追踪随访2年，观察患者子宫内膜息肉复发情况。 结果 研究组内膜组织IGF-1表达研究组术后明显低于术中，差异有统计学意义，对照组IGF-1的表达变化无差异性。随访2年对照组87例患者中7例子宫内膜息肉复发，复发率为8.05%，而研究组无一例复发，差异有统计学意义。 结论 左炔诺孕酮宫内释放系统可能通过抑制子宫内膜的IGF-1来降低子宫内膜息肉复发。 　　[关键词] 子宫内膜息肉；左炔诺孕酮宫内系统；胰岛素样生长因子 　　[中图分类号] R737.3 [文献标识码] B [文章编号] 1673-9701（2015）15-0031-03 　　[Abstract] Objective To study levonorgestrel intrauterine system on insulin-like growth factor-1 （IGF-1） in endometrium tissue for patients with endometrial polyps. Methods All 182 patients with endometrial polyps in our hospital from January 2010 to December 2011 were selected as research object， and randomly divided into control group（routine treatment group） 94 cases and observation group（levonorgestrel intrauterine system in uterus group）88 cases. The IGF-1 expression of endometrial biopsy specimens during intraoperative and rechected after 6 months were measurd by immunohistochemistry. Patients were followed up for 2 years to analyse endometrial polyp recurrence. Results The expressions of IGF-1 decreased significant in endometrium tissue of observation group with operation. But there were no significant differences in control group. Followed up for 2 years， the endometrial polyp recurrence was 8.05% in control group and without recurrence in study group. Conclusion Levonorgestrel intrauterine system may be involved in the inhibiting of the expression of IGF-1 then to induce the recurrence of endometrial polyps. 　　[Key words] Endometrial polyps； Levonorgestrel intrauterine system； Insulin-like growth factor-1 　　子宫内膜息肉（endometrial polyp，EMP）是指子宫内膜腺体和含有后壁血管纤维化的子宫内膜间质构成的突出于子宫内膜表面的良性结节[1，2]，常为单发，也可多发，是妇女最常见的子宫内膜病变之一，其癌变率为0.5%～4.8%，且其与子宫内膜癌的发生有相关性[3]。随着B超技术的发展，检出率日趋升高[4]。目前，国内外学者一致公认宫腔镜直视下息肉摘除术是息肉治疗的“金标准”，但是，我们发现有较多患者治疗后复发，因此找到子宫内膜息肉发生机制以及如何减少其治疗后的复发显得极为重要。左炔诺孕酮宫内系统（