神经纤维束状浸润与深部浸润型子宫内膜异位症疼痛相关性研究

发布时间：2018-06-21 15:37

本文选题：深部浸润型子宫内膜异位症 + 神经纤维　；参考：《中国实用妇科与产科杂志》2016年09期

【摘要】：目的探讨深部浸润型子宫内膜异位症(DIE)宫骶韧带病灶及阴道直肠隔病灶中神经纤维束状浸润(NFBI)情况及其与患者疼痛的相关性。方法收集2012-06-01—2015-01-01在中山大学附属第一医院妇科行手术治疗的64例DIE患者,采用免疫组化的方法分别检测宫骶韧带病灶和阴道直肠隔病灶中神经纤维蛋白基因产物9.5(PGP9.5)和GAP-43染色阳性的神经纤维。根据是否存在神经纤维束状浸润分为两组:NFBI阳性组和NFBI阴性组。比较两组患者痛经、肛门坠胀痛、性交痛和慢性盆腔痛程度,并探讨二者之间新生神经纤维密度的差异。结果宫骶韧带DIE病灶中NFBI阳性组痛经、肛门坠胀痛和慢性盆腔痛评分均比NFBI阴性组高,差异有统计学意义(均P0.05);性交痛评分两组差异无统计学意义(P=0.12)。阴道直肠隔DIE病灶中NFBI阳性组痛经、肛门坠胀痛、性交痛和慢性盆腔痛评分均比NFBI阴性组高,差异均有统计学意义(均P0.05)。宫骶韧带DIE病灶和阴道直肠隔DIE病灶中NFBI阳性患者的新生神经纤维(GAP-43染色阳性的神经)密度均比NFBI阴性患者高,差异均有统计学意义(P=0.001,P=0.007)。结论深部浸润型子宫内膜异位症病灶中神经纤维束状浸润与患者疼痛的严重程度相关,其原因之一可能是刺激新生神经纤维生长增加。
[Abstract]:Objective to investigate the neurofiber bundle infiltration (NFBI) in the sacral ligament lesions and the vagina rectum lesions in deep invasive endometriosis (DIEs) and its correlation with pain. Methods Sixty-four patients with DIE who underwent gynecological surgery in the first affiliated Hospital of Sun Yat-sen University in 2012-06-01-2015-01-01 were collected. Immunohistochemical method was used to detect neurofibrin gene product 9.5 PGP 9.5) and GAP-43 positive nerve fibers in the lesions of the uterine sacral ligament and the septum of vagina and rectum respectively. According to the presence of nerve fiber bundle infiltration, divided into two groups: NFBI positive group and NFBI negative group. The degree of dysmenorrhea, anus distention pain, sexual intercourse pain and chronic pelvic pain were compared between the two groups, and the difference of the density of neonate nerve fibers between the two groups was discussed. Results the scores of dysmenorrhea, anal distention and chronic pelvic pain in NFBI positive group were significantly higher than those in NFBI negative group (P 0.05), but there was no significant difference in sexual intercourse pain score between the two groups. The scores of dysmenorrhea, anal distention pain, coital pain and chronic pelvic pain in patients with positive NFBI were significantly higher than those in patients with negative NFBI (all P 0.05). The density of neonate nerve fibers with positive expression of GAP-43 in the lesions of the uterine sacral ligament and the septum of the vagina and rectum was higher than that in the patients with negative NFBI, and the difference was statistically significant. Conclusion the nerve fiber bundle infiltration in deep invasive endometriosis is related to the severity of pain, and one of the reasons may be to stimulate the growth of new nerve fibers.
【作者单位】：中山大学附属第一医院妇产科;中山大学中山医学院;
【基金】：中山大学2015年第二批学生业余科研项目(59) 广州市科技计划项目(201300000169) 广东省科技计划项目(2013B021800237)
【分类号】：R711.71

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