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目的:研究子宫内膜息肉术后放置左炔诺孕酮宫内缓释系统(the levonorgestrel intrauterine system,LNG-IUS)后宫腔灌洗液中细胞因子含量的改变。方法:22例子宫内膜息肉手术患者,术后采用LNG-IUS预防息肉复发,收集手术前及随访1年后宫腔灌洗液,采用ELISA法检测IL-1β、IL-6、IFN-γ、TGF-β1等细胞因子的变化情况。结果:子宫内膜息肉患者宫腔镜手术后采用LNG-IUS治疗1年后,其宫腔灌洗液中IL-1β、IFN-γ含量较术前明显降低,其差异具有统计学意义(P<0.01);术前22例标本灌洗液中均未检出TGF-β1,术后IL-6、TGF-β1含量明显增高,其差异具有统计学意义(IL-6,P<0.05;TGF-β1,P<0.01)。结论:LNG-IUS可诱导子宫内膜蜕膜样改变且局部炎症反应较轻,可能是预防子宫内膜息肉术后复发的原因之一。
Objective: To study the changes of cytokines in uterine lavage fluid after endometrial polyp surgery with levonorgestrel intrauterine system (LNG-IUS). Methods: Twenty-two patients with endometrial polyp surgery were treated with LNG-IUS to prevent the recurrence of polyp. The intrauterine lavage fluid was collected before surgery and one year after follow-up. The levels of IL-1β, IL-6 and IFN- TGF-β1 and other cytokines changes. Results: After one year of hysteroscopic surgery with endoscopic polypectomy, the levels of IL-1β and IFN-γ in uterine lavage fluid of patients with endometrial polyps were significantly lower than those before surgery (P <0.01). No TGF-β1 was detected in all the 22 specimens before operation, and the levels of IL-6 and TGF-β1 were significantly increased after operation (IL-6, P <0.05) -β1, P <0.01). CONCLUSION: LNG-IUS can induce endometrial decidua-like changes with mild local inflammation, which may be one of the reasons for the prevention of postoperative recurrence of endometrial polyps.