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当前位置:首页 > 行业资料 > 冶金工业 > 铜低密度聚乙烯复合材料宫内节育器引起子宫异常出血与铜离子浓度和血管生成的相关性
中国组织工程研究第20卷第34期2016–08–19出版ChineseJournalofTissueEngineeringResearchAugust19,2016Vol.20,No.34ISSN2095-4344CN21-1581/RCODEN:ZLKHAH5057·研究原著·邓婷,女,1982年生,福建省福州市人,主治医师,主要从事妇产科方面的研究。中图分类号:R318文献标识码:A文章编号:2095-4344(2016)34-05057-07稿件接受:2016-05-23放置宫内节育器者女性患者60例子宫异常出血组(n=32)无出血组(n=28)采用原子吸收法测定子宫内膜组织铜离子含量;免疫组织化学染色检测子宫内膜血管内皮生长因子表达,计数微血管密度=火焰原子吸收法测定模拟宫腔液中宫内节育器铜离子溶蚀量含铜宫内节育器的高溶蚀量可能导致子宫内膜组织铜离子含量的增加,造成子宫内膜血管内皮生长因子分泌增多,微血管密度增加,进而发生子宫异常出血取子宫内膜组织未放置宫内节育器对照组(n=20)取宫内节育器铜/低密度聚乙烯复合材料宫内节育器引起子宫异常出血与铜离子浓度和血管生成的相关性邓婷1,李晴2,陈丹1,谢熙1(1福建省妇幼保健院(福建省妇儿医院)妇产科,福建省福州市350001;2福建省立医院妇产科,福建省福州市350001)引用本文:邓婷,李晴,陈丹,谢熙.铜/低密度聚乙烯复合材料宫内节育器引起子宫异常出血与铜离子浓度和血管生成的相关性[J].中国组织工程研究,2016,20(34):5057-5063.DOI:10.3969/j.issn.2095-4344.2016.34.007ORCID:0000-0002-9765-4224(邓婷)文章快速阅读:文题释义:含铜宫内节育器:由于铜的作用显著提高了避孕效果,这主要是因为铜在宫腔内溶蚀而释放出铜离子,而铜离子具有生物毒性,可产生了一些不良反应,可见铜的溶蚀行为直接关系到含铜宫内节育器能否安全、长效使用。子宫异常出血:原因并非单一因素,主要有机械性压迫、炎症和异物反应、宫内生化环境改变、纤溶系统活性增加、前列腺素失衡等。含铜宫内节育器致出血机制错综复杂,以往研究多认为与解剖、内分泌、免疫因素等相关。近年来研究发现,子宫内膜微血管结构和功能变化与子宫异常出血密切相关,其中血管内皮生长因子为最重要的血管生成因子,有强烈增加血管通透性的作用,可能参与了含铜宫内节育器引起子宫内膜微血管结构和功能改变的过程。摘要背景:含铜宫内节育器表面的铜丝在宫腔内持续释放铜离子,避孕效果明显,但容易发生节育器异位、子宫异常出血、经期延长、腰腹酸痛等不良反应。目的:探讨铜/低密度聚乙烯复合材料宫内节育器致子宫异常出血与子宫内膜组织中铜离子浓度及血管内皮生长因子表达的关系。方法:纳入取铜/低密度聚乙烯复合材料宫内节育器女性患者60例,年龄25-40岁,分为子宫异常出血组(n=32)和无出血组(n=28);另选择未放置宫内节育器且月经周期正常的女性为对照组(n=20)。子宫异常出血组与无出血组在月经干净后4-7d内取宫内节育器的同时,刮取子宫内膜组织;对照组月经干净后4-7d内刮取子宫内膜组织。采用原子吸收法测定子宫内膜组织铜离子含量,免疫组织化学染色检测子宫内膜血管内皮生长因子表达,计数微血管密度;火焰原子吸收法测定模拟宫腔液中宫内节育器铜离子溶蚀量。结果与结论:①铜离子含量:子宫异常出血组高于无出血组(P0.05),无出血组高于对照组(P0.05);②铜离子溶蚀量:子宫异常出血组高于无出血组(P0.05);③组织学观察:与无出血组和对照组相比,子宫异常出血组血管内皮生长因子蛋白表达和微血管密度明显增加(P0.05);无出血组与对照组内皮生长因子蛋白表达与微血管密度比较差异无显著性意义;④子宫内膜血管内皮生长因子表达与微血管密度、铜离子含量呈正相关(P0.05)。⑤结果表明:铜/低密度聚乙烯复合材料宫内节育器置入后,子宫内膜组织中铜离子浓度过高可能引起血管内皮生长因子高表达,血管内皮生长因子通过多种途径增加子宫内膜微血管密度,促进微血管扩张、充血,导致子宫异常出血。含铜宫内节育器致子宫异常出血与子宫内膜组织中铜离子浓度及血管内皮生长因子的表达邓婷,等.铜/低密度聚乙烯复合材料宫内节育器引起子宫异常出血与铜离子浓度和血管生成的相关性P.O.Box10002,Shenyang110180(WomenandChildrenHospitalofFujian),Fuzhou350001,FujianProvince,China关键词:生物材料;材料相容性;含铜宫内节育器;子宫异常出血;铜离子浓度;血管内皮生长因子;微血管密度主题词:宫内避孕器;聚乙烯;子宫出血;组织工程Copperionconcentrationandangiogenesisastwocorrelatestoabnomaluterinebleedingcausedbycopper/low-densitypolyethylenenanocompositeintrauterinedeviceDengTing1,LiQing2,ChenDan1,XieXi1(1DepartmentofObstetricsandGynecology,MaternalandChildHealthHospitalofFujian(WomenandChildrenHospitalofFujian),Fuzhou350001,FujianProvince,China;2DepartmentofObstetricsandGynecology,FujianProvincialHospital,Fuzhou350001,FujianProvince,China)AbstractBACKGROUND:Toachieveexcellentcontraceptiveeffects,thecopperwireonthecopper-containingintrauterinedevicesurfacepersistentlyreleasescopperions,butectopicintrauterinedevice,abnormaluterinebleeding,menostaxisandwaistandabdominalpainareusuallyinevitable.OBJECTIVE:Toinvestigatethecorrelationofabnormaluterinebleedingcausedbycopper/low-densitypolyethylenenanocompositeintrauterinedevicewithcopperionconcentrationandexpressionofvascularendothelialgrowthfactorinendometrialtissues.METHODS:Totally60femalepatients,agedfrom25to40yearsold,hospitalizedfortakingintrauterinedeviceswereenrolled,andthosepatientsweredividedintoabnormaluterinebleedinggroup(n=32)andnon-bleedinggroup(n=28).Inthemeanwhile,another20womenwithoutintrauterinedevicesandwiththenormalmenstrualcyclewereselectedascontrolgroup.Patientsintheabnormaluterinebleedinggroupandnon-bleedinggroupunderwenttheremovalofintrauterinedeviceandscrapingendometrialtissueswithin4-7daysaftermenstruation;patientsinthecontrolgroupunderwentscrapingendometrialtissueswithin4-7daysaftermenstruation.Thecopperioncontentinendometrialtissueswasmeasuredbyatomicabsorptionmethod;expressionofendometrialvascularendothelialgrowthfactordetectedbyimmunohistochemicalstainingandthemicrovesseldensitycounted.Additionally,thecorrosionratioofcopperioninthesimulateduterinefluidwasdetectedusingflameatomicabsorptionspectroscopymethod.RESULTSANDCONCLUSION:Thecontentandcorrosionratioofcopperionintheuterineabnormalbleedinggroupwassignificantlyhigherthanthoseinthenon-bleedinggroup(P0.05),andthecopperioncontentofnobleedinggroupwassignificantlyhigherthanthatofcontrolgroup(P0.05).Theamountofcopperintheintrauterinedeviceofabnormaluterinebleedinggroupwashigherthanthatinnon-bleedinggroup(P0.05).Comparedwiththecontrolandnon-bleedinggroups,thevascularendothelialgrowthfactorexpressionandmicrovesseldensityweresignificantlyincreasedintheuterineabnormalbleedinggroup(P0.05);andthecontrolgroupandnon-bleedinggrouphadnosignificantdifferencesinthevascularendothelialgrowthfactorexpressionandmicrovesseldensity.Furthermore,therewasapositivecorrelationofthevascularendothelialgrowthfactorexpressionwithmicrovesseldensityandcopperioncontent.Inconclusion,afterimplantationofcopper/low-densitypolyethylenenanocompositesintrauterinedevice,thehighercopperionconcentrationinendometrialtissuesmayleadtotheover-expressionofvascularendothelialgrowthfactorthatincreasestheendometrialmicrovesseldensitythroughavarietyofways,andpromotemicrov
本文标题:铜低密度聚乙烯复合材料宫内节育器引起子宫异常出血与铜离子浓度和血管生成的相关性
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